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Management of PUJ obstruction

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quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -

"In those patients who had prenatal diagnosis of hydronephrosis, ultrasonography is performed in the first week of life. If hydronephrosis is confirmed, radionuclide studies are undertaken when the child is 6–8 weeks old in order to assess renal function and rule out obstruction. In those patients who present with clinical symptoms, a renal ultrasound is performed, and if it shows hydronephrosis without dilated ureters, the diagnosis is confirmed with radionuclide studies. The most commonly used radionuclides are diethylenetriamine pentaacetate (DTPA) and mercaptoacetyltriglycine (MAG3). Because MAG3 is excreted mostly by the renal tubules and yields better images in infants with compromised renal function and immature kidneys, we and others prefer to use traces with a high extraction rate (such as MAG3) in patients with hydronephrosis."

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