Although usually considered an adult problem, children are not immune to urolithiasis. Older children present with typical symptoms, and younger children may have signs mimicking those of colic. About 15% of children presenting to the emergency department who were ultimately diagnosed with urolithiasis by CT did not have hematuria (Persaud et al., 2009). Metabolic disorders are often the cause of pediatric stones, most often hypercalciuria (Peitrow et al., 2002).
The mainstay of treatment is a high fluid intake. Urinary alkalinization inhibits cystine and uric acid stones. For calcium-based stones, a diet low in sodium and oxalate and high in potassium is recommended. Excess intake of vitamins D and C is discouraged. Thiazide diuretics are also a treatment option. Gated and ungated shock wave lithotripsy has been successful treatment in children, with minimal morbidity (Shouman et al., 2009).
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