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)

In three women on chronic haemodialysis because of end-stage renal disease who were 40, 59, and 73 years of age respectively, spontaneous renal bleeding was diagnosed. The first two patients presented with acute flank pain and signs of sudden blood loss, the third one had chronic abdominal pain and anaemia. A CT scan demonstrated perirenal bleeding in all three patients and expansion into the retroperitoneal space in the first and third patient. In the latter two patients, acquired renal cysts had been visible during earlier abdominal ultrasound. None of the patients had severe hypertension, but all of them had received medication enhancing bleeding tendency, such as nadroparin, which was administered during haemodialysis. The first and the last patient were treated conservatively and survived. The second patient was haemodynamically unstable and underwent embolisation to stop the bleeding. She died in hospital after fifteen days due to the complications of a cardiac arrest. Abdominal CT or ultrasound is the technique of choice to evaluate patients with end-stage renal disease with loin pain or bleeding. Most of the time, conservative treatment suffices.
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PMID:[Spontaneous renal bleeding in haemodialysis patients]. 1875 14

We discuss the case of a young man presenting with "renal colic" whose flank pain however, turned out to be the result of renal infarction due to dissection of an accessory renal artery with fibromuscular dysplasia. The condition was diagnosed after exclusion of nephrolithiasis and work-up of new onset arterial hypertension developing in the later course. He was successfully treated by ethanol ablation (renal ethanol angioinfarction) and coiling of the accessory renal artery with resolution of hypertension in the absence of any antihypertensive medication.
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PMID:[Renal colic in a young man]. 1875 38

OBJECTIVES To evaluate, in a pilot prospective randomized trial, the safety, effectiveness and radiological recurrence of retroperitoneal renal cyst decortication compared with retroperitoneal decortication with wadding using perirenal pedicled fat tissue. PATIENTS AND METHODS From March 2004 to December 2007, 40 patients with simple renal cysts were enrolled and randomized; 22 (group A) had a simple retroperitoneal decortication (SRD) and 18 (group B) a decortication with wadding of the cyst using perirenal fat tissue (RDCW). The following variables were recorded: age, gender, side, size on ultrasonography/computed tomography (CT), location, operative duration, blood loss, complications, pathology, presence or absence of flank pain, hypertension, urinary tract compression or urinary infection. The primary endpoint of this trial was to evaluate and compare the efficacy of both treatments. Secondary endpoints were safety and pain, hypertension and the resolution of urinary tract obstruction. RESULTS In all, 40 cysts were treated; there were no bilateral cysts. The mean (sd) size on CT was 11.9 (1.84) cm in group A and 12.8 (1.25) cm in group B (P = 0.1). All the procedures were completed laparoscopically and no conversion was necessary. There were no intraoperative complications. The mean (range) hospital stay was 3.4 (3-6) days. There was no statistically significant difference between the groups for all variables assessed. There was a radiological recurrence in three patients (14%) in group A, but none in group B (all successful). CONCLUSION To be completely successful, with maximum safety and to prevent recurrences in the treatment of renal cysts, RCDW is recommended when a retroperitoneal approach is chosen, especially if the cyst is located anteriorly. When symptom relief is considered, RCDW duplicates the results obtained with SRD.
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PMID:Retroperitoneal decortication of simple renal cysts vs decortication with wadding using perirenal fat tissue: results of a prospective randomized trial. 1915 78

A 38-year-old, previously healthy man presented with flank pain after competing in a marathon. Initial laboratory tests and urinalysis were essentially normal. Both contrast enhanced-computed tomography and magnetic resonance angiography showed an infarcted region of the left lower kidney without renal artery dissection. Thromboembolism was suspected, but further testing was negative. The diagnosis of renal artery dissection was established by angiogram, showing dissection of the segmental branch. The patient remained normotensive, maintained normal renal function, and had resolution of pain symptoms prior to discharge. On the basis of our experience and review of the literature, renal artery dissection occurs in otherwise healthy men and often goes undiagnosed. The management strategy tends to be conservative unless the patient develops progressive decline in renal function or worsening hypertension, with an excellent prognosis. This case also shows the importance of discussing the pros and cons of extreme physical exertion with all patients.
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PMID:Renal artery dissection following marathon running. 1919 30

Pheochromocytomas are uncommon catecholamine-secreting tumors. The most common symptoms are of paroxysmal or sustained hypertension, or symptoms of paroxysmal adrenergic stimulation as palpitation, headache, and diaphoresis. The diversity of presentation often delays the diagnosis and is sometimes with catastrophic outcome. It had not been reported that acute myocardial infarction is a complication of ruptured pheochromocytoma. We describe a case with emergency department presented as acute myocardial infarction initially. On the following day, sudden drop of blood pressure and syncope attacked him. Coronary angiography revealed noncritical obstruction on proximal left anterior descending artery. After angioplasty, the patient still experienced episodes of hemodynamic collapse, and left flank pain developed. Abdominal computer tomogram demonstrated a large left adrenal tumor with fluid accumulation. Finally, the patient underwent surgical treatment and pathology confirmed the diagnosis.
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PMID:Ruptured pheochromocytoma presents as acute myocardial infarction. 1985 31

Nutcracker syndrome (NCS), the left renal vein hypertension due to compression between aorta and superior mesenteric artery, may present with hematuria, flank pain and proteinuria. We report a 6-year-old girl with episodic macroscopic hematuria who was diagnosed as NCS with Doppler ultrasound and 3D computerized tomography angiography. She was managed conservatively with spontaneous resolution of macroscopic hematuria. With this case we would like to emphasize that in children with hematuria and orthostatic proteinuria without an apparent cause, a great index of suspicion and appropriate imaging is necessary for the diagnosis of NCS.
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PMID:A rare cause of recurrent hematuria in children: Nutcracker syndrome. 2000 37

Autosomal dominant polycystic kidney disease (ADPKD) is not well described in black Africans while some data suggesting the disease is exceptional in this race. A retrospective study of patients with ADPKD followed in nephrology department of a teaching hospital in Dakar (January 1, 1995 to December 31, 2005) was therefore undertaken. Prevalence of ADPKD was one in 250. Mean age was 47 + or - 5 years with a predominance of male (57%). High blood pressure (HBP) was present in 68% of patients. Other renal manifestations were flank pain, hematuria and proteinuria. Majority of patients had impaired renal function at time of diagnosis. Extra-renal cysts were essentially found in liver (45.5%), pancreas and seminal vesicles. Main complications: ESRD (51%) occurred within a 6 year mean period, urinary tract infection (13%) and cerebral haemorrhage (2%). HBP control, in general needed 2 or more antihypertensive drugs. Fourteen patients died, ten patients had been on haemodialysis and four others died from uremic complications. In conclusion, ADPKD in black African adults is not rare and probably underdiagnosed. Early HBP and ESRD are likely more frequent than in other races. Earlier ultrasound detection and strategies to preserve renal function should be offered to at-risk individuals to improve outcomes.
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PMID:Patterns of autosomal dominant polycystic kidney diseases in black Africans. 2006 98

Wilms Tumor (WT) is a very rare malignancy in adults representing 1% of all renal neoplasms. It is however the most common renal tumor of children and adult patients are treated like pediatric cases. Bilateral tumors occur in 5% of adult cases. The typical presenting features are asymptomatic abdominal mass (most common), hematuria, pain, fever, and hypertension. As clinical presentation of WT is similar to that of renal cell carcinoma (RCC), it tends to be an unsuspected pathological diagnosis in most cases. The diagnosis of the tumor needs positive sonographic and computed tomography (CT) findings with histopathological confirmation. Prognosis of adult WT is relatively poor and resistant to chemotherapy. We present a case of wilms tumor in a 68 years old male patient with right sided non tender abdominal mass and occasional flank pain. The patient was normotensive but hematuric and radiological findings suggested right renal mass with enlarged lymph node and histopathological analysis revealed nephroblastoma associated with lymph node metastases.
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PMID:Wilms tumor in adult. 2039 30

A 96-year-old female visited our hospital with a complaint of right flank pain. She was under treatment for diabetes mellitus, hypertension and moderate renal dysfunction in the department of internal medicine. Computer tomographic (CT) scan showed a mass 12 cm in diameter compressing the right kidney and inferior vena cava. We diagnosed the right renal cyst. Eight weeks later, CT scan revealed a gradual increase of the mass. We punctured the tumor in order to reduce her complaint and investigate the rumor. Because contrast material could not be infused into the mass, needle biopsy was performed. Pathological examination revealed hypercellularity of spindle cells, that showed positive for CD34, vimentin, desmin and Mic-2, and negative for S100, alphaSMA, c-kit, AE1/3, p53 and bcl-2. The tumor was finally diagnosed as solitary fibrous tumor.
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PMID:[A case of retroperitoneal solitary fibrous tumor]. 2061 Sep 22

The urinary tract reconstruction in renal transplantation is usually performed by a ureterocystoneostomy according to Gregoire-Lich technique. In selected patients, native ureteral ligation with nephrectomy was done when end-to-end anastomosis for ureteroureterostomy was performed. Recently, some Authors have proposed the ligation of the native ureter without nephrectomy. We report our experience in the ligation of the native ureter with no associated nephrectomy. MATERIALS AND METHODS. In 978 renal transplantations performed from April 1986 through December 2006, we evaluated 68 recipients (69.5%) who underwent ureteral ligation without nephrectomy. Mean diuresis was 314 cc/day (range 0-1200 cc/day). Follow-up was 1 to 187 months. RESULTS. Only one patient (1.5%) required native nephrectomy for fever and abdominal pain. None of the other patients showed infections involving native kidney or flank pain during the follow-up. DISCUSSION AND CONCLUSION. Our experience confirms the safety and feasibility of native ureter ligation without omolateral nephrectomy. Nephrectomy is indicated in the case of coexistent intrinsic renal disease, such as non-treatable nephrovascular hypertension, symptomatic polycystic kidney disease, chronic renal infection.
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PMID:[Ligation of the native ureter in kidney transplant]. 2108 93


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