Q: In my 14 month old son during physical check up after birth, paediatrician observed some thing hard in the left abdomen. Immediately he did sonography, but he could not conclude anything except some cystic structure near spleen. After two months his mother observed some swelling in the scrotum, then we again went to doctor, he examined the scrotum and advised for ultrasound. Ultrasound revealed that there is about 76 ml fluid in the scrotum hence it is Hydrocoele. But during the ultrasound, I told the radiologist regarding that cystic structure in left abdomen, so he also checked the left abdomen and found that he could not trace the left kidney. He reported that there is a cyst on the kidney. Then doctor advised for CT scan of abdomen with contrast. CT scan revealed that left kidney is not functioning and there is no blood supply. Child health is good, he is gaining weight, eating normal, urinating normally. Kindly advise me about the urgency of surgery or shifting my son to India, as I am not interested in any surgery here in Tanzania.

A:Your child appears to have a multicystic dysplastic kidney on the left side. This is a structural abnormality in which the kidney has not developed properly and does not function at all. It would require removal sometime later. It is unusual to get 76 ml fluid in the hydrocoele of a small baby. In any case, hydrocoele do not require surgical correction as an emergency. It can be done at your convenience since he will not have symptoms due to it. Sometimes, hydrocoeles resolve spontaneously in the first year of life.