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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of the 97 patients with symptomatic renal angiomyolipoma not associated with tuberous sclerosis reported in the literature 13 have presented with a clinical picture of shock because of spontaneous rupture and massive retroperitoneal hemorrhage. Eight new patients with symptomatic renal angiomyolipomas are described, 2 of whom presented with an acute abdomen. Renal angiomyolipomas are essentially benign tumors. Several angiographic and pyelographic characteristics have been described but none appears to be unequivocally diagnostic. Because of the inability to make a precise preoperative diagnosis and the possibility of massive hemorrhage, nephrectomy is indicated in patients with such unilateral solid tumors in the absence of the tuberous sclerosis complex.
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PMID:Symptomatic renal angiomyolipoma: report of 8 cases, 2 with spontaneous rupture. 66 Jul 45

Angiomyolipoma is an uncommon benign tumor of the kidney. The tumor is composed of fat, smooth muscle, and blood vessels. The same pathological entity can appear in two clinically different forms, with or without tuberous sclerosis. We present two cases of renal angiomyolipomas with unusual manifestations. One was associated with tuberous sclerosis and both had the presentation of acute abdomen. Case one presented with epilepsy, angiofibroma, subungual fibroma, periventricular calcification, and bilateral renal angiomyolipomas. Tuberous sclerosis is characterized by these findings. Both cases had spontaneous hemorrhage with hypovolemic shock. Massive hemorrhage resulting in shock is uncommon and the incidence has been estimated to be about 10 per cent. In fact, many angiomyolipomas are clinically occult. The size of the tumor correlates well with the presence or absence of symptoms which include microhematuria, flank pain, hypertension and urinary tract infection. Abdominal CT is the preferred modality for diagnosis of angiomyolipoma. The most important finding is the presence of an intrarenal tumor with fat component which is recognized as a relative low density on CT. Our patients were hospitalized under the impression of angiomyolipoma after the CT study. In addition, the CT defined either the size of the tumor or the extension of the hemorrhage. Although many believe that renal angiography is not sufficient by itself to establish the diagnosis of angiomyolipoma, occasionally it is mandatory in the management of the tumor. The management is decided by two factors, the size of tumor and the clinical presentation. The attitude of management should include conservative treatment with regular follow-up, selective arterial embolization, enucleation, and partial or total nephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Unusual presentations of angiomyolipoma]. 179 71

A case of spontaneous hemorrhage in the retroperitoneal space, secondary to an angiomyolipoma of the kidney is reported in a 33 year old woman admitted with an acute abdomen. Differential diagnosis is discussed.
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PMID:[Spontaneous rupture of a renal angiomyolipoma]. 209 93

We report on 5 patients who presented with acute onset of abdominal pain, a palpable mass, and a rapid decrease in hemoglobin. All 5 patients had been entirely free of urological symptoms until shortly before hospitalization. Spontaneous rupture of a kidney with an underlying pathological condition was found in all cases. In 2 cases the underlying lesion was renal cell carcinoma, while in the other 3 cases the lesion was a renal angiomyolipoma, a polycystic kidney and hydronephrosis secondary to UPJ obstruction, respectively. The importance of considering the possibility of spontaneous rupture of the kidney in the evaluation of cases of an acute abdomen is stressed.
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PMID:Spontaneous rupture of the kidney: a cause of acute abdominal pain. Case report. 259 30

We report a case of renal angiomyolipoma in a patient who, following normal delivery, presented with abdominal pain and acute abdomen with severe hemodynamic compromise that led to hypovolemic shock. Following diagnosis by emergency exploratory laparotomy, a left nephrectomy was performed. We underscore the difficulty involved in the diagnosis of acute abdomen from hemoperitoneum resulting from a ruptured angiomyolipoma, and highlight the rarity of this condition. Our patient was submitted to radical surgery because of vessel (hilum) invasion. The tumor was benign and no complications were observed. Patient work up eight years postoperatively revealed no local or systemic evidence of disease.
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PMID:[Intraperitoneal hemorrhage after labor as manifestation of renal angiomyolipoma]. 271 3

We present the case of a 29-year-old, pregnant woman who, at 27 weeks' gestation, suffered an acute abdomen with hypovolemic shock that led to intrauterine fetal death in spite of an emergency laparotomy. The final diagnosis was ruptured renal angiomyolipoma, which caused a massive retroperitoneal hemorrhage.
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PMID:Massive retroperitoneal hemorrhage from spontaneous rupture of a renal angiomyolipoma during pregnancy. A case report. 793 4

Renal Angiomyolipoma (AML) is a rare benign tumor As it is usually asymptomatic and small, AML sometimes may cause acute abdomen by spontaneous rupture and hemorrhage that may be life threatening in some cases for which surgical management is necessary. A 58-year-old female patient was admitted for right side and right upper abdominal pain, nausea and vomiting. Right upper abdominal and right side sensitivity were remarkable on physical examination. Whole blood count revealed the ongoing with steady remarkable decrement in hematocrite and hemoglobin. Radiological examination showed right kidney mass with retroperitoneal hematoma. Patient underwent a right nephrectomy with mass excision. Her postoperative period was uneventful. On this case report we conclude that; angiomyolipoma may cause serious complications by the spontaneous rupture and life threatening hemorrhage. In case of massive hemorrhage and/or whole renal involvement, nephrectomy is the most feasible surgical treatment of all the other treatment methods.
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PMID:[Acute abdomen due to spontaneous renal angiomyolipoma rupture]. 1521 38

Angiomyolipoma of the liver or kidney is one of the clinical manifestations of tuberous sclerosis complex. However, concurrence of angiomyolipoma in both liver and kidney associated with tuberous sclerosis complex is a rare entity. Renal angiomyolipomas with large aneurysms confer a higher probability of rupture as compared to small aneurysms. Herein, we document a case of tuberous sclerosis coexisting with hepatic and renal angiomyolipoma in a 37 year-old woman who presented with an acute abdomen due to ruptured tumor. Computed tomography of the abdomen revealed multiple tumors over the bilateral kidneys and liver. A right nephrectomy was performed. During surgery, a liver biopsy was performed from which a preliminary diagnosis of necrosis was established. However, immunoreactivity staining using monoclonal antibody HMB-45 (Human Melanoma, Black) led to the final diagnosis of angiomyolipoma. We emphasized that pathologists and clinicians should be aware that cases of tuberous sclerosis complex may be associated with renal and hepatic angiomyolipoma. To avoid an inappropriate diagnosis, before diagnosing liver necrosis, immunohistochemical staining for HMB-45 is recommended.
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PMID:Concurrent hepatic and ruptured renal angiomyolipoma in tuberous sclerosis complex. 1560 11

This report deals with 11 examples of renal angiomyolipomas (AML) which appear to include an epithelial element as a part of the neoplasm in the form of gross or microscopic cysts-usually both. There were seven females and four males between the ages of 20 and 70 years with mean age of 45 years. Three of these were known to be symptomatic: intermittent flank pain and gross hematuria for 2 months; recurrent hematuria both before and after flank trauma and a third patient with acute abdomen due to a ruptured tumor blood vessel. Cysts were described in three of the six cases where radiographic data were available. Seven tumors were in the right kidney and four in the left. In gross descriptions, cysts were mentioned in seven and they ranged from 6.0 to 2.0 cm with a median and mean maximal diameter of 5.0 and 4.0 cm, respectively. Microscopically, virtually all of the tumors included multiple smaller cysts and these were lined by flat, cuboidal or columnar epithelium and occasionally hobnail epithelium. There was usually a subepithelial collar of poorly differentiated cells, but the solid element of all tumors was myomatous angiomyolipoma; only one case had any adipose tissue. A dominant histological feature was the prominent lymphatic channels-identical to those of lymphangiomyomas and myomatous or triphasic AMLs. They are much more conspicuous in these cystic cases. Immunohistochemically, all tumors tested were reactive with actin, desmin and HMB-45, with the latter being more intensely positive in the subepithelial collars. Estrogen and progesterone receptors were usually positive, also. The behavior of these lesions appears to be no different from that of other AMLs.
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PMID:Cystic angiomyolipoma of the kidney: a clinicopathologic description of 11 cases. 1652 75

Managing acute abdomen is a challenge for physicians in the emergency department. An immediate surgery is sometimes required for the hemorrhagic uropathy of renal angiomyolipoma. We present a case with left flank pain and findings of hematuria and pyuria. Abdominal and pelvic computed tomographic scans showed a 3 x 5-cm, fat-containing tumor at the left lower pole of the kidney and a bleeding and perirenal hematoma in the left perirenal space. An urgent left nephrectomy was lifesaving for the postoperative finding of renal angiomyolipoma. It is important to consider the possibility of the presence of such a tumor when spontaneous retroperitoneal hemorrhage and hypovolemic shock are encountered.
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PMID:Spontaneous hemorrhagic angiomyolipoma present with massive hematuria leading to urgent nephrectomy. 1827 26


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