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February 1946


Arch Surg. 1946;52(2):225-246. doi:10.1001/archsurg.1946.01230050229010


ANOMALIES.  —Heslin and Milner1 emphasized the importance of anomalies of the upper part of the urinary tract as the cause of damage to the kidneys. They referred to the work of Gutierrez and others in improving the diagnosis and treatment of these conditions. There are no pathognomonic symptoms of such anomalies of the urinary tract; general abdominal symptoms, sometimes without any symptoms referable to the urinary tract, often are present. The diagnosis depends on keeping the possibility of these anomalies in mind and on the use of intravenous urography in cases of vague pain in the abdomen and back and recurrent infection of the urinary tract. If intravenous urography is unsatisfactory, it must be supplemented by retrograde pyelography. Retrograde pyelography is also necessary to secure information to indicate the treatment to be used and to guide the surgeon. Removal of the factor causing the obstruction and resulting damage