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 series of 23 confirmed cases of pyonephrosis initially treated by percutaneous nephrostomy drainage were reviewed. Presentation was extremely variable, ranging from sepsis to asymptomatic bacteriuria. Fever, flank pain and leukocytosis were often absent. Ultrasonography was diagnostic in only 3 of 12 patients. In all, 17 patients had associated nephrolithiasis, and 5 patients ultimately required nephrectomy. Renal urine cultures were positive in 16 of 21 instances, with multiple organisms found in 8 of 21, and added bacteriological data not provided by bladder urine cultures in 11 cases. A pre-existing history of urinary tract infection, hypertension and malignancy was common. Percutaneous drainage was a safe, quick and effective diagnostic and therapeutic method.
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PMID:Pyonephrosis: diagnosis and treatment. 145 Aug 41

A 58-year-old man presented with left flank pain and a high grade fever. Investigations revealed left pyonephrosis with a left renal stone and a giant left ureteral stone. Nephroureterectomy was performed. The ureteral stone measured 13 cm. long and weighed 90 gm.
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PMID:Giant ureteral stone. 832 87

Ultrasound examinations were analysed in 24 patients with acute renal infections (pyelonephritis, focal pyelonephritis, renal abscess, pyonephrosis). Ultrasound examination is normal in mild inflammatory involvement of parenchyma, diffuse enlargement of parenchyma with echo-poor structure is found in severe involvement of parenchyma, localized echo-poor swelling of parenchyma is seen in focal pyelonephritis. Fever and flank pain are common to acute ureteral obstruction and acute pyelonephritis and ultrasound can differentiate between these diseases. Among mass lesions ultrasound can distinguish between focal pyelonephritis and abscess but cannot differentiate between tumor and focal pyelonephritis.
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PMID:[Ultrasound in acute renal infections (author's transl)]. 621 78

A series of 70 pyonephrotic kidneys drained by percutaneous nephrostomy tube was examined to evaluate the contribution of radiologic imaging to the diagnosis of pyonephrosis and to assess the diagnostic and therapeutic role of drainage by percutaneous nephrostomy catheter. The diagnosis of pyonephrosis is suspected when the clinical symptoms of fever and flank pain are combined with the radiologic evidence of obstruction to the urinary tract. Sonography gives a prompt diagnosis of hydronephrosis, and needle puncture of the kidney yields pus and establishes the presence of pyonephrosis. A percutaneous nephrostomy catheter is then inserted and serves for initial drainage of infected urine and for evaluation of residual kidney function before definitive surgery. The nephrostomy catheter is used for diagnostic nephrostograms, ureteral perfusions, therapeutic dissolution of stones, and indefinite drainage of the kidney. In 10 azotemic patients, the blood urea nitrogen and serum creatinine values returned to normal levels after antibiotic therapy and nephrostomy drainage of infection. Long-term evaluation of residual renal function by means of an excretory urogram or a renogram was available in another 26 patients and 25 of them showed function of the previously pyonephrotic kidney.
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PMID:Pyonephrosis: imaging and intervention. 635 66

Ultrasound examinations were analysed in 38 patients with acute renal infections (pyelonephritis, focal pyelonephritis, renal abscess, pyonephrosis). Ultrasound examination is normal in mild inflammatory involvement of parenchyma. In severe involvement diffuse enlargement of parenchyma with low density of echoes structure is found, while in focal pyelonephritis localized low density of echoes swelling of parenchyma is seen. Fever and flank pain are common to acute ureteral obstruction and acute pyelonephritis and ultrasound can distinguish between these diseases. Among mass lesions ultrasound can distinguish between focal pyelonephritis and abscess, but cannot differentiate between tumour and focal pyelonephritis.
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PMID:Ultrasound in acute renal inflammatory lesions. 665 72

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 61-year-old woman visited our hospital complaining of right flank pain and fever. The radiograph demonstrated multiple renal calculi. Radio renography showed no uptake in the right kidney. Therefore, we diagnosed her with pyonephrosis, and recommended open nephrectomy. However, she selected the conservative treatment with extra corporeal shockwave lithotripsy (ESWL). In spite of disappearance of multiple calculi, pyuria continued for 3 months after ESWL. Retrograde pyelography showed a fistula from the right pelvis into the duodenum. The patient was successfully treated by nephrectomy and duodeno-fistelectomy.
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PMID:[A case of spontaneous pyeloduodenal fistula]. 1041 Mar 20

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

Urinary calculi during pregnancy present not only a diagnostic challenge but also a management dilemma. In this retrospective study, we describe our experience with diagnosis and management of symptomatic urolithiasis in pregnant women. A total of 18 pregnant women were treated for urolithiasis at the Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, between 1999 and 2004. The incidence of symptomatic urolithiasis during pregnancy was 0.35%. Of the 20 stones found, nine were on the right side and 11 were on the left, and two patients had bilateral urinary stones. Most urolithiasis cases during pregnancy (55.5%) occurred in the third trimester. Flank pain (94.4%) was the most common clinical presentation. Conservative management was successful in 10 patients until the end of pregnancy and then definite treatment was performed. In four patients, a double-J stent was inserted successfully for persistent pain. In three cases with persistent pain, failure of double-J stent placement was treated with ureteroscopic lithotripsy under epidural anesthesia. One patient received percutaneous nephrostomy for persistent renal colic and pyonephrosis. Ultrasonographic evaluation of pregnant women with suspected renal colic is a reasonable diagnostic procedure. Ureteroscopy is another choice when conservative treatment fails.
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PMID:Management of symptomatic urolithiasis during pregnancy. 1752 6

Mucinous adenocarcinomas of the renal pelvis and ureter are among the rarest upper urinary tract neoplasm. We report a case of multifocal primary mucinous adenocarcinoma of the renal pelvis and ureter occurring in association with a staghorn calculus and pyonephrosis. A 68 year old man had suffered from right flank pain and upper abdominal swelling for one year. After a series of investigation, a right staghorn stone with pyonephrosis leading to non-functioning kidney was found. Right nephrectomy was performed. The pathological report showed mucinous adenocarcinoma with ureteric margin positive for tumour deposits. Patient was reoperated; right ureterectomy with removal of bladder cuff was done. Although uncommon, the possibility of a tumor should be kept in mind especially in patients with a long standing urolithiasis accompanied by hydronephrosis and/or infection.
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PMID:Primary mucinous adenocarcinoma of the renal pelvis and ureter. 2280 23


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