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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients commonly present to the emergency department with a suspected diagnosis of renal colic. A prospective study of 98 patients presenting with acute flank or abdominal pain or both was conducted to determine the diagnostic accuracy of ultrasound scan compared with excretory urography for the diagnosis of urinary tract calculi. All patients underwent standardized ultrasound scan and excretory urography as independent procedures. Two staff radiologists who reported the procedures were blinded to the results of the other diagnostic test and ultimate clinical outcome. All patients discharged home from the ED were followed to the hospital urology clinic. The diagnosis of urinary calculus was made only by identification of calculus at surgery or by reported passage of a stone by the patient. Of 85 patients available for follow-up study (56 men, 29 women; mean age, 40.5 years; range 18 to 77 years), calculi were identified in 69 (81%). Ultrasound identified calculi in 44 patients (sensitivity, 64%; specificity, 100%). Excretory urography identified calculi in 44 patients (identical sensitivity and specificity). When the presence of obstructive hydronephrosis only was used to diagnose renal calculi, ultrasound scan identified 59 patients (sensitivity, 85%; specificity, 100%) and excretory urography identified 62 patients (sensitivity, 90%; specificity, 94%). When the results of both diagnostic modalities were combined, calculi were identified in 59 patients (sensitivity, 85%; specificity, 100%) and hydronephrosis was seen in 66 patients (sensitivity, 95%; specificity, 94%). Our study shows that the diagnostic abilities of these procedures are equal in the detection of renal calculi.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The evaluation of suspected renal colic: ultrasound scan versus excretory urography. 265 8

Case 1: An 8-year-old boy consulted our clinic complaining of left flank colicky pain. He had a past history of the same episode. Ultrasonographic study was promptly performed. Left hydronephrosis was detected. At operation, left aberrant renal vessel was resected, and he has been free of pain. Case 2: A 65-year-old woman consulted our clinic because of abdominal pain and fever, who occasionally had the same episode. The existence and disappearance of the right hydronephrosis could be observed by emergency ultrasonography and following ultrasonic study, and the stenosis of the right lower ureter caused of cystitis cystica and glandularis was pointed out by retrograde ureterography. Diuresis ultrasonography by furosemide was performed to evaluate urinary tract stricture. In case 1, an incomplete obstruction pattern was obtained after operation, and in case 2, a complete obstruction pattern was shown. The emergency ultrasonography and diuresis ultrasonography were useful for the diagnosis and observation of intermittent hydronephrosis.
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PMID:[2 cases of intermittent hydronephrosis--usefulness of ultrasonography]. 266 May 22

A case of right ureteral obstruction secondary to right common iliac aneurysm presenting as right hydronephrosis is reported and the literature is reviewed. A 66-year-old man was admitted to our hospital with lower abdominal pain and was treated by bypass operation with artificial vessel and uretero-ureterostomy of right ureter under the diagnosis of right ureteral stenosis secondary to right iliac aneurysm. Histological examination showed arteriosclerotic aneurysm and a fibrillary inflammatory change in peri-ureteral tissue without any hemosiderin-laden macrophages. Intravenous pyelography showed improvement of right hydronephrosis 45 days after operation. To date 11 cases including our case have been reported in Japan, 10 in males and the other in a female. Initial symptoms were either lumbago or an abdominal mass with palpitation in many cases. The treatment was by resection of aneurysm with bypass grafting or ureterolysis.
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PMID:Ureteral stenosis secondary to common iliac aneurysm: a case report and review of the literature in Japan. 307 74

From January to December 1983, 12,207 specimens of urine were examined for ova of Schistosoma haematobium and 753 (6.17%) were positive. From this group, 44 adult patients were investigated for urinary tract abnormalities. Haematuria was the commonest presenting symptom (81.8%) followed by lower abdominal pain (77.3%) and dysuria (68.2%). Urinalysis revealed proteinuria in 55.5%, leucocyturia in 90.9% and microhaematuria in 88.6% of patients. Twenty-four hour protein excretion ranged from 230 mg to 2.2 g (mean 960 mg). Serum creatinine was raised in one patient (2.2 mg dl-1), Urological abnormalities included calcification of the bladder in 36.4%, ureteric strictures and dilatations in 65.9%, hydronephrosis in 9.1%, squamous cell carcinoma of the bladder in 4.5%, vesicle calculus in 2.3%, and multiple granulomatas in the bladder in 2.3% of the patients. The results of the study suggest that a sizeable population of this area is at risk of developing urological complications and consequently chronic renal insufficiency.
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PMID:Urinary schistosomiasis in Maiduguri, north east Nigeria. 311 28

The occurrence of hydronephrosis and hydroureters during pregnancy has been termed physiological, inasmuch as it is seen in more than 80%, most frequently and most pronounced in primigravida. The dilatation develops during the second trimester, and becomes more prominent on the right side, is only seen above the linea terminalis and disappears within a few weeks after birth. The condition is not seen in women whose ureters do not cross the pelvic brim. The extent of the dilatation can be reduced by placing the woman on the side least affected or in the knee-elbow position. After a survey of the literature, the conclusion is reached that today there is every probability that hydronephrosis during pregnancy develops as a result of compression of the ureters between the pregnant uterus and the linea terminalis. It has not been demonstrated that the change in hormonal balance during pregnancy is of importance. The clinical significance of hydronephrosis lies in the association between ureteral obstruction and the high frequency of ascending urinary tract infection during pregnancy and in the understanding of the importance--in the treatment of infection--of improving drainage by means of a change in position. Isotope renographic studies seem to show a possible relationship between bilateral ureteral obstruction and the development of pre-eclampsia. Similarly, it appears that acute hydronephrosis or worsening of an existing hydronephrosis has been somewhat overlooked as a possible cause of uncertain abdominal pain during pregnancy. These conditions should be examined by means of ultrasonography, and an attempt at treatment by a change in position should be made. In cases of continued pain or affected renal function, treatment should consist of the insertion of a ureteral catheter.
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PMID:Hydronephrosis during pregnancy: a literature survey. 328 Mar 55

Hydronephrosis and urinoma are extremely rare complication of the abdominal aneurysm. A case of the aorto-iliac aneurysm associated with right hydronephrosis and urinoma is reported. The patient is 71 year-old female. She was admitted because of right lower abdominal pain. A diagnosis of the infrarenal abdominal aneurysm with involvement of the common iliac artery and right hydronephrosis due to ureter obstruction was made. A leakage of urine from right renal pelvis (urinoma) was also confirmed. A staged treatment for hydronephrosis was selected. At first, percutaneous nephrostomy was made under ultrasonographic guidance. Urinoma was completely disappeared thereafter. Two weeks later, the aneurysm was replaced with a Y-shaped Dacron graft and the right ureter was mobilized from the perianeurysmal fibrous tissue. On the 35th postoperative day, balloon ureteroplasty was performed through the nephrostomy catheter. Three months after operation, nephrostomy catheter was successfully withdrawn because of improved urinary passage through the right ureter. We emphasize the efficacy of staged surgical treatment combined with percutaneous nephrostomy for the abdominal aneurysm associated with hydronephrosis.
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PMID:[A staged surgical treatment of an abdominal and iliac aneurysm associated with hydronephrosis and urinoma: report of a case]. 336 33

348 cases of abdominal aortic aneurysm were reviewed for typical features of inflammatory aneurysm (IAAA) (marked thickening of aneurysm wall, retroperitoneal fibrosis and rigid adherence of adjacent structures). IAAA was present in 15 cases (14 male, 1 female). When compared with patients who had ordinary aneurysms, significantly more patients complained of back or abdominal pain (p less than 0.01). Erythrocyte sedimentation rate was highly elevated. Diagnosis was established in 7 of 10 computed tomographies. 2 patients underwent emergency repair for ruptured aneurysm. Unilateral ureteral obstruction was present in 4 cases and bilateral in 1. Repair of IAAA was performed by a modified technique. Histological examination revealed thickening of the aortic wall, mainly of the adventitial layer, infiltrated by plasma cells and lymphocytes. One 71-year-old patient operated on for rupture of IAAA died early, and another 78-year-old patient after 5 1/2 months. Control computed tomographies revealed spontaneous regression of inflammatory infiltration after repair. Equally, hydronephrosis due to ureteral obstruction could be shown to disappear or at least to decrease. IAAA can be diagnosed by computed tomography with high sensitivity. Repair involves low risk, but modification of technique is necessary. The etiology of IAAA remains unclear.
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PMID:[Inflammatory abdominal aortic aneurysm]. 339 98

We report a case of a 37 year old man who presented with vomiting and colicky abdominal pain and who was found to have microscopic haematuria. Radiological-examination showed a right hydronephrosis apparently caused by a paracaecal tumour extending to involve the right ureter. This was resected and proved histologically to be a mesenteric fibromatosis. The patient has none of the factors predisposing to the development of this lesion, in particular Gardner's syndrome. Eight months following surgery he appears to have made a full recovery. Previous publications on this rare intra-abdominal neoplasm are reviewed.
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PMID:Mesenteric fibromatosis with ureteric stenosis. 342 65

We report a rare instance of chemical pericystitis in a 60-year-old man who had undergone transurethral resection of a bladder tumor and subsequent intravesical instillation of doxorubicin. The patient had a high fever lasting for 18 days, lower abdominal pain and mild hydronephrosis. Extravasation of doxorubicin through the resected and thinned region of the bladder wall seemed to be responsible for this complication. The lesion improved spontaneously without any sequela.
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PMID:Chemical pericystitis: a rare complication of intravesical doxorubicin. 371 78

This case report presents an unusual case of primary IUD-associated ovarian actinomycosis, which spread to the sigmoid causing intestinal obstruction. A 43-year-old gravida 3, para 2, had her 1st IUD from 1978-80 (Gyne-T) and her 2nd IUD from 1980 to October 1983 (Multiload). Right lower abdominal pain led to hospitalization in May 1983. A tender nodular mass was palpated in the left pelvic area. Laboratory results confirmed the presence of inflammation. Rapid improvement followed a course of laxatives and cephalosporin antibiotics, and the patient was discharged with the diagnosis of acute sigmoid diverticulitis. 2 months later, a double contrast examination of the large intestine was done and showed severe narrowing of the sigmoid colon over a distance of 12 cm and occasional sharp recesses. Colonoscopy showed a spastic stricture of the sigmoid with massive edema of the otherwise intact mucosa at 18 cm. Computer tomography of the abdomen showed a large, focally cystic infiltrative mass in the pelvis with congestion and displacement of both ureters as well as bilateral hydronephrosis, predominantly on the right side. The descending colon was congested. The patient was readmitted to hospital with the tentative diagnosis of ovarian cancer when her general condition deteriorated. She complained again of abdominal pain in the right lower quadrant and alternating diarrhea and constipation. Pyrexia and the hematological findings suggested sepsis. The pelvis contained a predominantly leftsided nodular mass and a brown fetid discharge was coming through the cervix. The IUD was removed and treatment with ampicillin and clindamycin was started with rapid improvement in the patient's condition. Obstruction with extreme distention of the colon required emergency laparotomy. An inflammatory mass was found in the pelvis consisting of a right-sided ovarian tumor, bilateral hydrosalpinges, and a tightly encased sigmoid colon. The dilated caecum had a large necrotic area in its wall which necessitated caecostomy and double-current sigmoidostomy after subtotal hysterectomy and bilateral salpingo-oophorectomy. The patient made a good recovery. As recently as the 1950s, primary pelvic actinomycosis was a rarity. In the last 4 years alone, 20% of all reported cases of actinomycosis involved the female genital tract. The percentage of cases found among IUD users has been continuously increasing and in the last 2 years all published cases were IUD users. The presence of actinomyces in vaginal smears always is indicative of the presence of a foreign body, most commonly and IUD.
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PMID:IUD-associated ovarian actinomycosis causing bowel obstruction. 374 Sep 65


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