Fraley Syndrome

When Fraley syndrome , also syndrome of upper calyx or Upper Chalice Syndrome called, is an intermittent dilatation of the upper calyx of the kidney due to compression of the neck cup, often by an aberrant vessel. The change was first described by the American urologist Elwin Fraley in 1966.

clinic

Clinically, there is unilateral and intermittent pain in the flank area with tenderness and knocking pain, as well as micro and / or macro hematuria . When complications can concretions or circumscribed inflammation occur at the upper pole of the kidney. Increased mobility of the kidneys (ren mobilis) is common.

Diagnosis

Both in the ultrasound examination and in an X-ray examination such as the excretory urogram there is an isolated expansion of the upper calyx group with narrowing of the calyx neck.

The cause can be an aberrant vessel, but also a congenital narrowing of the calyx (dysplasia) or an acquired cephalic stricture z. B. after an inflammation or stone loss.

Differential diagnosis

A distinction must be made between extensions of several or all calyx groups in hydronephrosis (obstructive) and in megacalicosis .

treatment

A causal therapy is only possible surgically.

Individual evidence

^ EE Fraley: Vascular obstruction of superior infundibulum causing nephralgia. A new syndrome. In: The New England Journal of Medicine . Volume 275, Number 25, December 1966, ISSN 0028-4793 , pp. 1403-1409, doi: 10.1056 / NEJM196612222752503 , PMID 5956366 .
↑ Whonamedit
^ FC Sitzmann: Pediatrics. Diagnostics - therapy - prophylaxis. 6th edition. Hippocrates 1988, ISBN 3-7773-0827-7 , p. 932.
↑ Bernfried Leiber (founder): The clinical syndromes. Syndromes, sequences and symptom complexes . Ed .: G. Burg, J. Kunze, D. Pongratz, PG Scheurlen, A. Schinzel, J. Spranger. 7., completely reworked. Edition. tape 2 : symptoms . Urban & Schwarzenberg, Munich et al. 1990, ISBN 3-541-01727-9 .
↑ G. Benz, E. Willich: [The syndrome of the upper calyx in children with chronic pyelonephritis (author's transl)]. In: Advances in X-Ray and Nuclear Medicine. Volume 121, Number 4, October 1974, ISSN 0015-8151 , pp. 445-454, PMID 4373341 .
↑ K. Ebel, E. Willich, E. Richter (Eds.): Differentialdiagnostik in der Pediatric Radiologie. Vol. II, Thieme 1995, ISBN 3-13-128101-4 , p. 396
↑ A. D'Amico, L. Lusuardi et al. a .: Experience in the surgical treatment of Fraley's syndrome. In: European Urology . Volume 38, 2000, pp. 410-414, doi: 10.1159 / 000020316 , PMID 11025378 .

[1] EE Fraley: Vascular obstruction of superior infundibulum causing nephralgia. A new syndrome. In: The New England Journal of Medicine . Volume 275, Number 25, December 1966, ISSN 0028-4793 , pp. 1403-1409, doi: 10.1056 / NEJM196612222752503 , PMID 5956366 .

[2] Whonamedit

[3] FC Sitzmann: Pediatrics. Diagnostics - therapy - prophylaxis. 6th edition. Hippocrates 1988, ISBN 3-7773-0827-7 , p. 932.

[Leiber-4] Bernfried Leiber (founder): The clinical syndromes. Syndromes, sequences and symptom complexes . Ed .: G. Burg, J. Kunze, D. Pongratz, PG Scheurlen, A. Schinzel, J. Spranger. 7., completely reworked. Edition. tape 2 : symptoms . Urban & Schwarzenberg, Munich et al. 1990, ISBN 3-541-01727-9 .

[5] G. Benz, E. Willich: [The syndrome of the upper calyx in children with chronic pyelonephritis (author's transl)]. In: Advances in X-Ray and Nuclear Medicine. Volume 121, Number 4, October 1974, ISSN 0015-8151 , pp. 445-454, PMID 4373341 .

[6] K. Ebel, E. Willich, E. Richter (Eds.): Differentialdiagnostik in der Pediatric Radiologie. Vol. II, Thieme 1995, ISBN 3-13-128101-4 , p. 396

[7] A. D'Amico, L. Lusuardi et al. a .: Experience in the surgical treatment of Fraley's syndrome. In: European Urology . Volume 38, 2000, pp. 410-414, doi: 10.1159 / 000020316 , PMID 11025378 .