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

Ureteral obstruction is a rare extraintestinal manifestation of Crohn's disease (CD). We report the case of a 20-year-old man who presented with fever, diarrhoea, and lower abdominal pain. Diagnostic studies confirmed CD and revealed an abdominal mass obstructing the right ureter and hydronephrosis. Ureteropelvic junction (UPJ) obstruction was diagnosed. Despite an elemental diet and mesalazine therapy, the hydronephrosis persisted, and the patient eventually required surgery. Successful laparoscopic pyeloplasty was performed. This is the first report of CD associated with UPJ obstruction. Ureteral obstruction as a complication of CD is discussed.
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PMID:A case of Crohn's disease with hydronephrosis caused by ureteropelvic junction obstruction. 1689 17

Abdominal actinomycosis causing hydronephrosis in a patient with a ventriculoperitoneal shunt is very rare. A 27- year-old female patient was admitted complaining of lower abdominal pain. She had undergone ventriculoperitoneal shunt surgery 10 years ago. Abdominal Ultrasonography and a CT scan demonstrated an inflammatory mass in the lower left quadrant of the abdomen causing obstructive hydroureter and hydronephrosis. Laparotomy revealed a diffusely infiltrating mass involving the small bowel, mesentery, and sigmoid colon, and a 1cm perforation in the sigmoid colon. Actinomycosis was diagnosed upon histological examination. After treatment with antibiotics and surgery, the patient's condition improved.
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PMID:Abdominal actinomycosis associated with a sigmoid colon perforation in a patient with a ventriculoperitoneal shunt. 1694 52

Retroperitoneal fibrosis is an uncommon inflammatory disease which is characterized by the development of a fibrous process that surrounds the major vessels and organs located within the retroperitoneum. Isolated as an idiopathic expression or associated with several other diseases in its secondary form, retroperitoneal fibrosis remains relatively of rare occurrence and as a result, is devoid of either diagnostic or therapeutic definitive recommendations. We report the observation of one case admitted in the emergency room for abdominal pain induced by left hydronephrosis. Radiographic exploration with contrast-enhanced studies evidenced retroperitoneal fibrosis causing left ureteric obstruction. Therapeutic approach was based on corticosteroids and ureteral drainage which prevented recurrence while fibrosis was almost reversed six months later.
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PMID:[Idiopathic retroperitoneal fibrosis: unusual cause of abdominal pain. A case report]. 1702 Feb 26

In a retrospective analysis we studied the case histories of 31 children who had been seen in our department for investigation of pelvic ectopic kidney between January 1994 and June 2005. The evaluation of each involved the medical history, ultrasound examination, VCUG, and DMSA scan or MAG3 diuresis renogram. Of the 31 children, 21 (67.7%) had initially been referred to our department for further investigation and clarification because renal agenesis was suspected. In the remaining 10 (32.3%) children the pelvic kidney was an incidental finding observed during investigation of various other conditions. Overall, 7 (22.6%) of the 31 were symptomatic (recurrent urinary tract infections, abdominal pain, hypertension, hydronephrosis), while 77.4% (24/31) were completely free of symptoms at the time of follow-up. Ultrasound revealed that the ectopic kidney was on the left in 64.5% (20/31) of these cases. Nuclear scans performed both at the time of the initial diagnosis and at follow-up were available for 11 of the 31 children and showed a mild improvement of the partial function of the pelvic kidney, from a mean of 25.6% to a mean of 34.6%. In conclusion, whenever renal agenesis is suspected on ultrasonographic examination, the investigator should first consider renal ectopia; ultrasound examination with the bladder full is the definitive diagnostic procedure. For asymptomatic cases we recommend regular ultrasound monitoring of the kidney -- at first every 6 months and later once a year. In cases with complex anatomy MRI is a suitable method for further diagnostic work-up.
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PMID:[Pelvic kidney in childhood. Specific features, concomitant pathologies and useful diagnostic investigations]. 1722 Dec 48

Urinary ascites in adults is usually secondary to iatrogenic or traumatic injuries. A case of a 69-year-old male with abdominal pain and decreased renal function is described. Ultrasound showed bilateral hydronephrosis and ascites. Computed tomography revealed retroperitoneal fibrosis complicated by a rupture at the right ureteropelvic junction and urine extravasation in the perirenal and intraperitoneal spaces. Delayed scans showed leaking of contrast media from the anterior perirenal space to the peritoneal cavity. The urinary ascites resolved using a double-J stent.
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PMID:Urinary ascites due to retroperitoneal fibrosis: a case report. 1732 37

Dermatomyositis associated with genitourinary malignancies is not uncommon. However, only a few cases associated with ureteral stricture have been reported, and ureteral rupture is even rarer. A 56-year-old woman with dermatomyositis who had been treated with prednisolone, cyclophosphamide, and azathioprine for 2 months presented with fever, hematuria, and abdominal pain for 2 days. Radiographic imaging revealed bilateral ureteral spontaneous rupture and intraperitoneal urinoma formation. Urine cytology and endourologic examinations showed no evidence of genitourinary malignancy. Ureteral urine leakage was managed successfully by drainage through percutaneous catheter and bilateral double-J ureteral stenting. The stents were removed 9 months later. Follow-up intravenous urography 12 months after ureteral stent placement showed good renal function with left mild hydronephrosis and hydroureter above the previous rupture site. Bilateral ureters were patent and there was no evidence of contrast medium extravasation from either ureter. Diuretic renal scanning also showed bilateral nonmechanical obstruction with left-side mild hydronephrosis without urine extravasation. Dermatomyositis can be complicated with spontaneous ureteral rupture. Conservative management with urinary diversion and stenting is feasible.
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PMID:Dermatomyositis associated with bilateral ureteral spontaneous rupture. 1738 71

We report our experience of laparoscopic nephrectomy on a girl with giant hydronephrosis of a horseshoe kidney. An 8-year-old girl presented with a 4-month history of right abdominal pain. We performed laparoscopic nephrectomy for the non-functioning moiety of a horseshoe kidney secondary to uretero-pelvic junction obstruction. Laparoscopic nephrectomy is a feasible and safe method with good indications especially for children with a horseshoe kidney disease.
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PMID:Laparoscopic nephrectomy for a girl with giant hydronephrosis of a horseshoe kidney. 1764 11

A 75-year-old man had been admitted to another hospital because of left abdominal pain, and was given a diagnosis of left hydronephrosis and acute pancreatitis. After a JJ stent insertion and medication, he was transferred to our hospital for further examinations. US and EUS revealed a chronic pancreatitis-like pattern and multicystic lesion in the pancreas head and body. At that time enhanced CT findings showed an extrapancreatic low density area to be inflammatory change, extending from the pancreas body to the left crus of the diaphragm and posteriorly the spreading from the left crus of the diaphragm via the left urinary duct into the left iliopsoas muscle, in which MRI revealed partial high intensity. ERCP and MRCP showed focal irregular narrowing of the pancreatic duct of unknown cause, and we decided that an internal pancreatic fistula due to pancreatitis had induced left ureteral obstruction, caused by a protein plug or alcohol. Follow-up 6 months later showed that extrapancreatic spreading of the low density area had markedly regressed without any change in the ureteral obstruction.
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PMID:[A case of intraductal papillary mucinous neoplasm with internal pancreatic fistula causing left ureteral obstruction]. 1767 27

Hydronephrosis and the evaluation of obstructive uropathy are the most common indications for MR urography in our practice. Typically our patients fall into one of two groups: infants with antenatal hydronephrosis and older children who present with abdominal pain, hematuria or urinary tract infection. Obstruction in children is usually chronic and partial. Intermittent episodes of increased pressure occur when the urine production exceeds the capacity for drainage. MR urography uses a fluid and diuretic challenge to assess the hydronephrotic kidney. High-quality anatomic images provide a morphologic assessment of the hydronephrotic system. Although it is relatively straightforward to determine if a system is not obstructed on the basis of the renal transit time (RTT), no single parameter is adequate to fully characterize obstruction. By evaluating the changes in signal intensity in the renal parenchyma following contrast administration, the hydronephrotic systems are classified as compensated or decompensated. Delayed RTT and the presence of urine-contrast levels indicate stasis. Calyceal transit time and the difference between the volumetric and the Patlak differential renal function (vDRF-pDRF) are measures of the physiologic changes within the kidney. Additionally, MR urography provides prognostic information by assessing the quality of the renal parenchyma and identifying uropathy preoperatively. MR urography combines both anatomic and functional information in a single test and is capable of providing a comprehensive evaluation of obstructive uropathy that could ultimately help select those patients most likely to benefit from surgical intervention.
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PMID:MR urography evaluation of obstructive uropathy. 1807 89

We present a case of primary ureteral carcinoma composed of both transitional cell carcinoma and mucinous carcinoma. A 79-year-old woman visited her home doctor with the chief complaint of right lower abdominal pain. Abdominal computed tomographic scan (CT) disclosed a tumor measuring about 5 cm in diameter at the right lower quadrant of the abdomen. Percutaneous nephrostomy was performed for hydronephrosis and pyonephrosis. The urinary cytology revealed class V, transitional cell carcinoma. Re-abdominal CT showed further enlargement of tumor diameter, but the primary site of the tumor was not identified. Her general condition worsened, and she died 42 days after her initial complaint. Pathologic examinations upon autopsy revealed both mucinous carcinoma and transitional cell carcinoma in the right ureter. Pathogenesis and management of this rare condition are discussed.
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PMID:[Primary ureteral carcinoma composed of both transitional cell carcinoma and mucinous carcinoma: a case report]. 1820 27


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