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September 27, 1965

Perirenal Contrast Medium: A New Roentgenographic Sign of Neonatal Urinary Ascites

Author Affiliations

From the Department of Radiology, University of Texas Southwestern Medical School, and Parkland Memorial Hospital, Dallas. Dr. Dockray is now at the Irwin Army Hospital, Fort Riley, Kan.

JAMA. 1965;193(13):1121-1123. doi:10.1001/jama.1965.03090130049019

IF, DURING excretory urography, a halo of opaque contrast medium is seen about the kidney of an ascitic infant, the physician may possess a diagnostic key to that catastrophic disorder, neonatal ascites. This rare disease, marked by a 95% death rate, is characterized by massive quantities of fluid in the peritoneal cavity, quantities which accumulate in the perinatal period.1 This ascites is said to be the result of obstructive malformations in the gastrointestinal and genitourinary tracts.2,3 The subject of this communication was affected by neonatal urinary ascites and, fortunately, survived. The successful therapeutic regimen was based on urographic findings and proves the value of this distinctive roentgenographic halo sign. It is the purpose of this communication to call attention to this form of uropathy and its diagnosis.

Report of a Case  A 10-day-old moribund boy with severe respiratory distress was discovered to have ascites as demonstrated by an