Duplicating collecting system and vesicoureteral reflux
A mother’s intuition and the skills of a dedicated pediatric urologist set a seriously ill Mississippi child on the path to good health and a bright future.
In the fall of 2020, 10-year-old Jude Strickland’s health was declining to the point where he was in constant discomfort. Pain on the left side of his body became so intense that he couldn’t stand for long, was distracted in class, and spent sleepless nights tossing and turning and groaning. He couldn’t participate in any of the school and church activities he enjoyed and became increasingly withdrawn.
“He wasn’t my kid anymore,” his mom, Whitney, said. Jude was treated for ailments ranging from a pulled muscle to strep throat to growing pains. “But he never got better," Whitney added.
A registered nurse herself, Whitney suspected that Jude may be suffering with a congenital disorder called duplicating collecting system (DCS), also known as ureteral duplication, where one kidney has two ureters. Ureters are the tubes that carry urine from the kidney. Whitney was born with the condition and experienced similar symptoms at age 13. She had successfully received treatment at Children’s of Alabama. After watching their son continue to decline, she and her husband, Sam, decided to seek a second opinion at the hospital where Whitney had been a patient as a child.
Arriving at Children’s in early 2021, the family met Dr. Carmen Tong. “Dr. Tong let me unload at that first visit,” Whitney said. “I told her that I was so overwhelmed because I knew something was wrong.”
Imaging confirmed that Jude did indeed have DCS along with vesicoureteral reflux, a condition where urine moves backward from the bladder to the kidneys. The reflux was causing repeated infections and ultimately scarred part of his left kidney. Further testing revealed that Jude’s left kidney was working at only 10% capacity.
Initial treatment included dietary changes and endoscopic surgery, but Jude received only temporary relief. When the severe pain returned, Tong recommended the removal of the diseased part of his kidney. The surgery was performed in December 2022.
“The morning after the surgery, Jude said ‘I don’t hurt!’” Whitney said. “He had just had major surgery, yet the post-surgical pain was less than the pain he’d been experiencing for months.”
Jude’s recovery has been astounding. He grew five inches in six months and is running cross country and practicing karate. He plays six different instruments in his school and church bands, and as a Beta Club officer, he is excelling academically.
Two years after surgery, Jude continues to be pain-free and no longer needs the frequent post-op check-ups with Tong that were required earlier in his recuperation. Like others his age, he is focused on the future. “Dr. Tong gave Jude his health back,” Whitney said, “but she gave him his life back, too.”
