During the past fifteen months we have been able to study, clinically and at autopsy, infection of the upper urinary tract in an infant. The case is of interest for the following reasons:
The preoperative course emphasizes the necessity of team work between the urologist and the pediatrician in the application of present day diagnostic methods of urology to every case in which medication alone is not successful in renal infections of children.
Even though mechanical causes of stasis in the ureter are eliminated, adequate drainage is not provided if neuromuscular changes of congenital origin are present in the ureteral wall.
Such an atony associated with thickening of the ureteral wall is analogous to the changes found in the megalocolon, and is followed by stagnation of the urinary current.
REPORT OF CASE
History.—A girl, aged 8 months, was admitted to the pediatric service on Sept. 24,