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

Two patients with solitary kidneys had ureteral obstruction caused by iliac artery aneurysms. Both patients were treated successfully with ureterolysis and temporary proximal diversion. Iliac artery aneurysms generally remain asymptomatic; however, patients may have urologic complaints (such as hematuria, flank pain, anuria, or a pulsatile urinary stream), and severe complications may develop as a result of an obstructive uropathy. Diagnosis is confirmed by cystoscopy when a mass is present, intravenous pyelography, retrograde pyelography, and arteriography. Treatment must be individualized with consideration of the etiology of the aneurysm and condition of the patient. Surgical correction of the aneurysm may be appropriate. Ureterolysis, with proximal diversion as a temporary safety valve, is a useful procedure particularly when the patient has a solitary kidney.
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PMID:Ureteral obstruction of solitary kidneys by iliac artery aneurysms. 83 47

A retrospective study of 36 patients with xanthogranulomatous pyelonephritis who underwent nephrectomy at our hospital was performed. The disease occurred most frequently in middle-aged women with a history of recurrent urinary tract disorder. There were 2 cases of focal xanthogranulomatous pyelonephritis, 2 associated with emphysematous pyelonephritis, 2 that manifested as fistula formation between the colon or skin, and 1 with deep sinus formation into the hip joint that presented as septic arthritis. Flank pain and fever were the most frequent complaints. Escherichia coli (67%) and Proteus mirabilis (26%) were the most common organisms isolated from the voided urine, kidney and blood stream. Cephalothin plus gentamicin or tobramycin were the drugs of choice before surgical intervention.
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PMID:Xanthogranulomatous pyelonephritis: experience in 36 cases. 173 87

Renal AML are rare benign tumors of the kidneys consisting of fat tissue intermixed with thick-walled blood vessels and smooth muscle. Due to the easy access to modern imaging techniques more and more AML are detected incidentally during diagnostic evaluation of common urological disease before getting symptomatic (mostly flank pain, hematuria). The presence of a highly echodense renal mass on ultrasound and the detection of even small amounts of fat in CT usually allows to establish the diagnosis of AML. If these procedures give still equivocal results, angiography and MRI may become necessary. When report a case of a patient with AML where all the imaging techniques including magnetic resonance were nonconclusive. The correct diagnosis could only be established by histological examination after surgical resection. Indeed, the presence of a large hematoma had masked all the characteristic features of AML in this case.
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PMID:The role of imaging techniques in diagnostic evaluation of angiomyolipomas. 175 64

Four cases of a form of obstructive uropathy previously unreported in children are described. All presented with oligoanuria and either flank pain or fluid retention and had evidence of crystalline sludge in their lower ureters. Three cases had an underlying crystalluria.
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PMID:Ureteric sludge syndrome. 202 14

Idiopathic hypercalciuria (IH) in adults is recognized as a cause of urolithiasis. If IH is symptomatic, the symptoms are hematuria, renal colic, or obstructive uropathy with or without infection. In children, IH has been linked to the spectrum of urinary symptoms including hematuria, pyuria, dysuria, recurrent urinary infections, abdominal or suprapubic pain, proteinuria, and the frequency-urgency syndrome. Hematuria may appear prior to the appearance of stones, and thiazide therapy appears to prevent stone formation by decreasing urinary calcium excretion. This report describes an older adolescent with hematuria and flank pain. His urinary chemistry values were not consistently typical of IH, but a thiazide trial with withdrawal challenge was diagnostic. His case is remarkable because, though essentially an adult, his disease was typical of prepubertal disease. Adolescents with unexplained urinary symptoms should be evaluated for IH. The urinary calcium-creatinine ratio may not be elevated, and timed urinary calcium may be equivocal. In some cases a thiazide trial may be valuable and cost effective.
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PMID:Atypical idiopathic hypercalciuria in an adolescent. 318 67

The diagnostic work-up of the urologic patient must be tailored to the presenting symptom complex, carefully selecting from the many modilities available, those most likely to establish the diagnosis and extent of the suspected lesions. Intravenous urography is the most rewarding initial procedure for many presenting symptoms, including suspected masses, pyuria, hematuria, and flank pain. Nuclear imaging is particularly effective in differentiating renal lobulations from true masses, in demonstrating parenchymal scarring in chronic pyelonephritis when the IVP is equivocal, and in assessing the decrease in perfusion and function in obstructive nephropathy when the IVP is indeterminate. It is the preferred procedure for acute renal infarction and acute tubular necrosis and has a greater sensitivity of detection for renal trauma than the IVP. Gallium-67 renal imaging appear helpful in the detection of occult pyelonephritis or interstitial nephritis. However, it cannot differentiate focal acute pyelonephritis from abscess or abscess from neoplasm. Ultrasoneography is the initial procedure of choice in the differentiation of cystic from solid renal masses and in anuria or oliguria. When a kidney fails to visualize by IVP or nuclear imaging, it can confirm or rule out obstruction. In upper tract infections, it may demonstrate renal or perirenal abscess. Although retrograde pyelography is performed less frequently in recent years, it remains extremely useful in confirming and relieving obstructive uropathy and in delineating tumors of the collecting system. Computed tomography effectively demonstrates hydronephrosis, renal abscess, tumors, and cysts and retroperitoneal involvement. More experience is needed to judge the efficiency of "dynamic" CT for the quantification of renal function. Renal angiography remains invaluable as a secondary procedure (as opposed to initial screening) in renal trauma, vascular anomalies, and in renal tumors to delineate the anatomy of the arterial supply and possible renal vein involvement.
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PMID:Medical imaging of renal diseases-suggested indication for different modalities. 724 59

Two adult patients with acute renal vascular occlusion with infarction are described. Both patients were believed to have ureteral colic. In each instance, the correct diagnosis was overlooked at the initial emergency department visit. An uncommon clinical entity that continues to go undiagnosed, acute vascular occlusion of the kidney must be considered in the differential diagnosis of acute flank pain. Absence of the nephrogram phase on an intravenous pyelogram (IVP) should alert emergency physicians to this possible diagnosis and to the need for further work-up. Subsequent diagnostic evaluation should begin with renal ultrasonography to rule out obstructive uropathy. If hydroureteronephrosis is not present, follow-up perfusion studies are necessary to confirm the absence of renal perfusion. Greater awareness of this uncommon clinical entity and its potential morbidity is essential to correct diagnosis and management.
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PMID:Acute renal vascular occlusion: an uncommon mimic. 815 6

In the context of increasing flank pain, hematuria, lack of toxicity, and absence of a stone on imaging studies, the cause may be a urinary tract infection due to Staphylococcus saprophyticus. When symptoms suggest renal lithiasis but intravenous pyelogram, renal ultrasonography, or renal cortical scan is negative for obstructive uropathy and dimercaptosuccinic acid scanning suggests acute pyelonephritis, initial antibiotic selection should include coverage for this organism, pending urine culture and sensitivity results.
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PMID:Urinary tract infection due to Staphylococcus saprophyticus: a clinical presentation mimicking a renal stone in a male adolescent. 860 65

Here we present an 83-year-old woman who was referred to our hospital and had had left flank pain and oligouria for 3 days. Plain abdominal film and ultrasonography revealed left ureteropelvic junction stone with obstructive uropathy. The serum level of creatinine fell to 3.1 mg/dl from 7.6 mg/dl after ureteral catheter drainage was given 5 days after admission. Then a left pyelolithotomy was performed and a tumor of 2 x 1 x 1 cm over the lower pole of the left kidney was found incidentally. Partial nephrectomy was performed in consideration of her age and poor renal function although the biopsy result showed it to be carcinoma. The final pathological report and immunohistochemical study results proved that it was neuroendocrine carcinoma. To our knowledge, this is the first case of primary renal neuroendocrine carcinoma to be treated using conservative surgery. The clinical course was acceptable, since she had been found to be free of disease during regular follow-up of 2.5 years with the creatinine level of about 2.5 mg/dl.
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PMID:Partial nephrectomy for incidental primary renal neuroendocrine carcinoma: case report. 1049 35

Acute flank pain is commonly encountered in the emergency department, and often requires imaging to establish its cause. For decades intravenous urography and sonography have been the primary media for evaluating flank pain. Recently, noncontrast spiral CT (NCSCT) has been shown to be accurate and highly successful in diagnosing cause in such cases. We evaluated its use in the diagnosis of acute flank pain. During a 7-month period, 147 such cases had NCSCT imaging immediately after initial evaluation in the emergency department. Using a spiral CT scan without oral or i.v. contrast media, 109 of 147 cases were found to have ureteral stones, and 34 others to have other urological conditions unrelated to the cause of pain; 38 CT scans were negative for ureterolithiasis and in 14 non-urological disease was diagnosed. NCSCT is a valuable diagnostic technique for patients in the emergency department with flank pain. It rapidly and accurately detects ureteral stones causing renal colic and also detects extra-urinary causes of acute flank pain.
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PMID:[First experiences in non-enhanced spiral computed tomography for diagnosis of acute flank pain]. 1097 47


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