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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case report of intrarenal true cyst of the pancreas is presented. The patient presented with flank pain. Her diabetes and hypertension were well-controlled. The cause of the pain was presumed to be a cystic renal mass, which proved to be of pancreatic origin only after the pathologic confirmation from the nephrectomy specimen.
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PMID:Intrarenal pancreatic cyst. 186 68

A case of isolated adrenal cryptococcosis is reported. A patient with a history of diabetes mellitus had symptoms of left flank pain. Roentgenological and sonographic findings of the adrenal gland were indicative of a malignant tumour. Tissue obtained from surgery showed fungal granuloma and a poorly encapsulated cryptococcal organism was identified by special stains. A post-operative serum cryptococcal antigen test was positive, and the patient was successfully treated with surgery and a course of amphotericin B. After a 7-month follow-up period, there is no evidence of recurrence or dissemination.
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PMID:Isolated cryptococcosis of the adrenal gland. 189 53

A 51-year-old male patient with diabetes mellitus consulted his home doctor because of high fever and right flank pain. Urinalysis showed marked pyuria. Treatment with antibiotics was not completely effective, and he was referred to our hospital for further examination and treatment. CT scan showed an abnormal gas shadow in right renal parenchyma. He was diagnosed with emphysematous pyelonephritis and right subcapsular nephrectomy was done after the control of diabetes mellitus. We reviewed 57 cases of emphysematous pyelonephritis including our case in the Japanese literature, and we discussed about its etiology, symptomatology, choice of treatment and prognosis.
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PMID:[A case report of emphysematous pyelonephritis]. 218 91

A 36-year-old woman with diabetes mellitus complained of left flank pain and high fever. Drip infusion pyelogram (DIP) did not visualize the left kidney, but revealed crescent-shaped gas formation within the left renal shadow. Abdominal computerized tomography showed a subcapsular shadow in the left kidney. Because her symptoms was aggravated, left nephrectomy was performed under the diagnosis of emphysematous pyelonephritis. There was no manifestation of her prior symptoms after the operation, and she was discharged on the 19th postoperative day. In Japan, 43 cases of emphysematous pyelonephritis have been reported in the literature. These 43 cases were studied clinically and in comparison to the cases reported in Western countries. The male-to-female ratio was approximately 4 to 1, in contrast to the Western ratio of female preponderance. The age of the patients showed its peak at the 50-60's, the mean age being not significantly different from that of Western patients. 37% of the patients had the affected side on the right, 56% on the left, and 7% bilaterally. This was comparable to the results of Western countries. 93% of the subjects suffered from diabetes mellitus as the basal malady, which was comparable to that in Western studies. However, patients afflicted with urinary passage impairment accounted for 14%. This incidence was lower than that reported in Western studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Emphysematous pyelonephritis a case report and review of the literature--comparative study with Japan and other countries]. 266 95

Perinephric abscess is a life-threatening but treatable process. Most infections of the perinephric space occur as a result of extension of an ascending urinary tract infection, commonly in association with nephrolithiasis or urinary tract obstruction. A large portion of the mortality is the result of failure to diagnose this entity in a timely fashion. This failure may be because of the frequently obscure or nonspecific nature of the clinical presentation. Blood cultures as well as urine cultures may fail to identify correctly the bacterial pathogens responsible for the abscess. Perinephric abscess should be considered in the differential diagnosis of any patient presenting with a urinary tract infection that fails to respond promptly to antibiotic therapy, particularly in those known to have anatomical abnormalities of the urinary tract or diabetes mellitus. Consideration of this diagnosis should enter into the differential diagnosis of fever with abdominal pain or flank pain. Early recognition of perinephric abscess and prompt drainage, either percutaneously or surgically, in combination with appropriate antibiotic coverage, should reduce dramatically the morbidity and mortality from this infection.
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PMID:Perinephric abscess: the missed diagnosis. 304 58

We report the case of a 59-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain of three days duration. The diagnosis was established by a plain abdominal radiograph in the emergency department. Aggressive rehydration, control of diabetes, broad-spectrum antibiotic therapy, and early right nephrectomy resulted in rapid clinical improvement. Emphysematous pyelonephritis is rare and often fatal. Survival depends on early diagnosis and aggressive combined medical and surgical management.
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PMID:Emphysematous pyelonephritis: an emergency indication for the plain abdominal radiograph. 328 24

A case of emphysematous pyelonephritis is presented and a review of literatures is made. A 67-years-old woman with diabetes mellitus, complained of severe left flank pain and high fever and was referred from the department of gastroenterology. A computed tomography film demonstrated gas in the left renal parenchyma and a diagnosis of emphysematous pyelonephritis was made. She was in a state of shock and died after 4 days of conservative treatment. Emphysematous pyelonephritis is a rare, life-threatening disorder and 85 cases in the world have been reported to date. Our case is the 18th one in Japan. Its etiology, symptomatology, treatment and prognosis are discussed.
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PMID:[Emphysematous pyelonephritis complicated by liver cirrhosis and diabetes mellitus: a case report and a review of the literature]. 331 33

The records of 47 patients with a perinephric abscess diagnosed from 1975 to 1986 at 8 San Francisco Bay Area hospitals were reviewed. The mean age was 51 years. Fifty-five percent were females and 45%, males. The left kidney was affected in 47% of cases, the right kidney in 40%, both in 4%, and a transplanted pelvic kidney in 9%. Fever (55%), chills or diaphoresis (47%), flank pain (40%), abdominal pain (40%), and nausea or vomiting (32%) were the most common presenting symptoms. About half the patients had symptoms for 1 week or less and 12% had no symptoms. Fever was documented before diagnosis in 88% of patients. Abdominal mass (13%) or tenderness (49%), and flank mass (9%) or tenderness (42%) were seen less frequently, and 11% of patients did not have fever, flank, or abdominal findings. The most frequent underlying conditions included previous urologic surgery (45%), previous urinary tract infection (38%), diabetes mellitus (36%), and urinary tract stones (36%). Cultures of perinephric abscesses yielded gram-negative aerobes in 52% of patients, primarily Escherichia coli. Staphylococcus aureus was isolated in 26% of patients and anaerobes in 17%. A single pathogen was isolated in 71% and multiple isolates in 29%. Of interest and great potential therapeutic importance was culture of anaerobes, primarily Bacteroides spp. in 17%, Enterococcus spp. in 7%, and Candida albicans in 7%. Positive blood and urine cultures identified perinephric abscess organisms exactly in 58% and 37% of cases, respectively. Routine laboratory tests such as the white blood cell count and urinalysis were insensitive and non-specific for perinephric abscess. Leukocytosis and anemia at admission were seen in slightly more than half of the patients. For radiologic diagnosis, computerized tomographic scanning was most helpful. Ultrasound and intravenous pyelography were falsely negative in about one-third of cases. Mortality (13%) was low in this series when compared with earlier studies, and probably reflects modern medical care. Six patients (13%) died during hospitalization, 2 of whom had diagnosis of PNA established only at autopsy. Drainage of the perinephric abscess was carried out by open surgical drainage in 64% of patients, percutaneous drainage in 19%, and both in 13%. The initial procedure, whether open surgical drainage or percutaneous catheter drainage, was usually successful. Late complications included nephrocutaneous fistulas in 3 patients and disseminated candidiasis in 1 patient.
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PMID:Perinephric abscess. Modern diagnosis and treatment in 47 cases. 335 13

A case of emphysematous pyelonephritis is presented. A 49-year-old male with diabetes mellitus complaining of high grade fever attack and right flank pain was referred from internal medicine. KUB demonstrated that the right ureter, pelvis and calyces were filled with gas. Anti-bioticus was given intensively and the abnormal gas shadow on plain film disappeared before RP was done, but high grade fever attack persisted and right nephrectomy was undergone. After this operation, the fever was relieved and the patient was discharged at the 30th day post-operatively. A search of available literature in Japan has disclosed only 17 reported cases. Diagnostic methods, treatment, complication and etiology are discussed.
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PMID:[Emphysematous pyelonephritis: report of a case]. 383 25

A case of emphysematous pyelonephritis is presented. A 54-year-old woman with diabetes mellitus was admitted because of bilateral ureteral stones. Five days after bilateral ureterolithotomy, she developed left flank pain, chills and fever. Plain x-rays of the abdomen (KUB) showed an enlarged left kidney with a giant gas shadow on the left renal area and no evidence of stone shadow. Drip infusion pyelogram revealed a decrease in the left renal function and the presence of the gas in the pyelocalyceal system. Contrast-enhanced computerized tomograms confirmed the presence of the gas in the parenchyma and pyelocalyceal system. The patient was treated conservatively with intensive antibiotic therapy, intravenous fluids and control of diabetes mellitus. After 3 weeks of therapy, the gas shadow disappeared, and a good recovery of renal architecture and function was achieved.
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PMID:[Emphysematous pyelonephritis: report of a case]. 401 46


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