Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 57-year-old male patient was admitted to our hospital for left flank pain and a slight increase in serum creatinine. He had left hydronephrosis and extrinsic stenosis of left lower ureter shown by intravenous and retrograde pyelography. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a mass along the bilateral lower ureters, the left side of which was larger (5 x 3 x 4 cm). After surgical exploration and biopsy of the tumor the patient was diagnosed as having xanthogranulomatous inflammatory pseudotumor. No malignant findings were observed. Tumor size spontaneously decreased to 20% of the original size at 2 weeks after laparotomy. The patient underwent ureterolysis because of prolonged left hydronephrosis. Approximately 3 years after development of disease, hydronephrosis has improved and the pelvic tumor has almost diminished.
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PMID:[A case of retroperitoneal pseudotumor (xanthogranuloma)]. 950 3

Localized amyloidosis of the ureter is a relatively rare condition. We report a case of primary localized ureteral amyloidosis. A 66-year-old man was referred to our hospital complaining of right flank pain and gross hematuria. From the right hydronephrosis and irregular margin of the right lower ureter seen on the anterograde pyelography, we could not rule out a right ureteral malignancy. Total nephroureterectomy was performed and histologic examination showed ureteral amyloidosis. Amyloid was classified immunohistochemically as Alambda type. After all examinations for secondary or systemic amyloidosis were negative, primary localized amyloidosis of the ureter was confirmed.
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PMID:Primary localized amyloidosis of the ureter. 971 51

Cisplatin is a potent tubular toxin with a high incidence of nephrotoxicity. Carboplatin is considered less nephrotoxic but can still cause tubular injury and interstitial nephritis in patients who have been previously treated with cisplatin. The affected individuals usually have nonoliguric renal failure with a urine output of more than a liter per day. We present a 57-year-old white woman with no history of renal disease who underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for stage IC ovarian carcinoma. One month later, she received chemotherapy with paclitaxel (Taxol) and carboplatin. On the following day, she developed frank hematuria and flank pain associated with a diminished urine output. Intravenous pyelogram (IVP) showed bilateral hydronephrosis with a total blockage of dye flow at the level of intraureteral lucencies consistent with bilateral blood clots. Her coagulation profile and uric acid was normal. Her acute renal failure (ARF) spontaneously resolved in the following 24 hours, with a brisk diuresis presumably due to clot lysis. The follow-up IVP showed a resolution of obstructive changes. A review of the literature shows a previous case in which high doses of carboplatin were implicated as the cause of hemorrhagic cystitis, presumably by toxicity to transitional epithelium of the bladder. We believe that the current case represents carboplatin-induced damage to the transitional epithelium in the renal pelvi and ureters causing gross hematuria and blood clots, resulting in bilateral ureteral obstruction and hydronephrosis.
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PMID:Carboplatin-related hematuria and acute renal failure. 1007 93

The objective of this study was to determine whether helical computed tomography (CT) performed without oral or intravenous contrast agents is accurate in the evaluation of patients with suspected acute renal colic. One hundred consecutive patients with suspected renal colic or ureteral colic were referred by our institution's emergency department for unenhanced helical CT scans. We reviewed the original radiographic report for each patient and recorded the size and location of ureteral calculi and other concurrent urinary tract calculi, if any. We also recorded the presence or absence of hydronephrosis, hydroureter, perinephric edema, and periureteral edema. A total of 49 patients had ureteral calculi, 17 patients had only renal calculi, and 34 patients had no stones. Forty-nine patients had ureteral calculi, and 40 (82%) of these 49 patients had associated CT signs including hydroureter and periureteral edema. Calculi were present in the proximal ureter in 11 patients, the midureter in seven patients, and the distal ureter including ureterovesical junction in 31 patients. Calculi were seen elsewhere in the urinary tract and renal pelvis in 44 patients. Other diagnostic tests and stone passage were used to confirm the CT diagnosis of ureteral stones. The sensitivity and specificity of helical CT in evaluating ureteral calculi were 100% and 94%, respectively. Sixteen extraurinary lesions were detected in 34 patients who had no urinary calculi. Most extraurinary lesions (81%) were deemed the cause of acute flank pain. The room time for CT averaged 26 min, compared to 69 min for intravenous urography (IVU). The charge for CT was $600 compared to $400 for IVU in our institution. Unenhanced helical CT was fast and accurate in determining the cause of colic and proved to be highly accurate for emergency situations.
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PMID:Can noncontrast helical computed tomography replace intravenous urography for evaluation of patients with acute urinary tract colic? 1019 91

Ureteral obstruction occurred in two patients after laparoscopic Burch cystourethropexy. Both women experienced right flank pain and right hydronephrosis. Cystoscopy revealed transmural passage of suture anterior and lateral to the ureteral orifice on the right side. One patient was managed by suprapubic cystoscopy to release the suture; the other was managed by preperitoneal laparoscopy to release suture at the bladder neck. In both patients efflux of urine was seen immediately from the ureteral orifice after suture release. Ultrasound confirmed prompt resolution of hydronephrosis. Cystoscopy with confirmation of patent ureters should be performed after every case of retropubic cystourethropexy. Retrograde rigid cystoscopy may not afford adequate access to remove transmural sutures. Placement of sutures at the bladder neck from medial to lateral may avoid entrapment of the intramural portion of ureter. (J Am Assoc Gynecol Laparosc 6(2):217-219, 1999)
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PMID:Ureteral compromise after laparoscopic Burch colpopexy. 1022 37

A 33-year-old man with chronic alcoholism presented with left flank pain and a low-grade fever. He had a previous history of left renal calculi treated by extracorporeal shockwave lithotripsy 3 months previously at a local hospital. Since a stone was impacted at the ureteropelvic junction resulting in septic hydronephrosis, a D-J catheter was introduced to relieve the condition. He underwent fluid therapy with antibiotics. Elective pyelolithotomy was scheduled on day 10. However, persistent pyonephrosis necessitated the removal of the infected kidney. Hyperthermia over 40 degrees C continued after surgery and dark urine developed on postoperative day 2. Rhabdomyolysis was suspected because of myoglobulinemia with a high creatine phosphokinase level. Systemic cooling and treatment with fluid and diuretics saved his renal function. He survived episodic malignant hyperthermia and was discharged from intensive care unit on postoperative day 5.
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PMID:[Rhabdomyolysis following nephrectomy for pyonephrosis: a case report]. 1033 Nov 80

A case of idiopathic retroperitoneal fibrosis is reported. The patient was a 63-year-old man with the complaint of right flank pain, general fatigue and weight loss. Intravenous pyelography revealed right hydronephrosis and peripelvic extravasation. Abdominal computed tomography showed subcapsular urinoma of the right kidney and mass lesion surrounding the aortic bifurcation. Retrograde pyelography demonstrated a narrow segment at the middle portion of the right ureter through which the ureteral catheter could be easily passed. Magnetic resonance imaging showed a low-intensity mass on T1 weighted images and a heterogeneous mass on T2 weighted images. Steroid therapy was selected under the diagnosis of idiopathic retroperitoneal fibrosis with subcapsular urinoma of the right kidney. Prednisolone was administered for 60 days, resulting in the complete disappearance of the urinoma.
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PMID:[A case of idiopathic retroperitoneal fibrosis with renal subcapsular urinoma resolved by steroid therapy]. 1036 44

In this study we describe 22 cases of retrograde ureteral stent placement in pregnant women with therapy-resistant flank pain due to hydronephrosis. Eleven were primiparous and one patient expected twins. Eight of 22 patients presented symptoms of pyelonephritis. In 21 cases the hydronephrosis was located on the right and in 4 cases it was bilateral. Maximal lower calix diameter was 12 mm (range 9-22 mm). With the exception of two cases, sonographically controlled stent placement was performed under local anesthesia without sedation. All patients were painfree within 6 days and were given prophylactic low doses of antibiotic until the day of delivery. Renal function remained within the normal limits. Double-J stent displacement occurred in 3 patients - of which one underwent nephrostomy. Postnatal examination demonstrated urolithiasis in 4 of 19 patients. This study provides evidence for effectiveness of retrograde ureteral Double-J stent placement as a therapeutic option in cases of severe symptomatic hydronephrosis during pregnancy with a low morbidity rate.
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PMID:[Ureteral stent placement in hydronephrosis during pregnancy]. 1050 8

A case of pyonephrosis with high levels of serum CA19-9 antigen is reported. A 71-year-old woman was admitted with right flank pain. Computed tomography and ultrasonography showed severe hydronephrosis and hydroureter due to a right ureter stone. Laboratory data revealed a high level of serum CA19-9. However, no tumor was found in the pancreas, gallbladder, liver, gastrointenstinal tract or genitourinary tract. Drip infusion pyelography showed a non-functioning pattern of right kidney. Therefore, right nephroureterectomy was performed for right pyonephrosis. Histological examination revealed chronic inflammation. Malignant cells were not seen in the resected specimen. The serum CA19-9 levels before and after operation were 102.9 U/ml and 24 U/ml, respectively, being normal after the operation. Immunohistochemical examination revealed the presence of CA19-9 antigen in the urethelium, indicating its expression in the specimen. To our knowledge this might be the first case of pyonephrosis associated with high levels of serum CA19-9 antigen.
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PMID:[A case of pyonephrosis caused by ureteral stones with elevated serum levels of CA19-9]. 1054 Jul 10

Acute flank pain is a common emergency department presenting symptom, and bedside ultrasound is being used increasingly in its evaluation. Emergency renal ultrasonography concentrates on the focused presence or absence of hydronephrosis as is often seen in patients with acute flank pain secondary to renal colic. We present three cases in which other abnormal sonographic signs not commonly taught prompted further investigation, revealing renal cell carcinoma. Baseline knowledge of sonographic characteristics of tumors will benefit the occasional emergency patient who has unsuspected renal carcinoma.
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PMID:Ultrasonography of flank pain in the emergency department: renal cell carcinoma as a diagnostic concern. 1064 44


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