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 pelvic hematoma arising from a leaking left hypogastric aneurysm resulted in the acute onset of bilateral flank pain and bilateral ureteral obstruction in a sixty-four-year-old black man. Intravenous pyelogram revealed a pelvic hematoma with narrowing of both lower ureters, hydroureteronephrosis, and anterior bladder displacement. Cystoscopy revealed anterior displacement of the bladder base which appeared pulsatile. Arteriography confirmed the leaking hypogastric aneurysm, and successful surgical ligation was performed.
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PMID:Leaking left hypogastric artery aneurysm causing bilateral ureteric obstruction. 45 97

A total of 481 cases of retroperitoneal fibrosis (RPF) presented in the literature have been reviewed. Ten additional cases from this hospital have been added. One etiological factor, methysergide, has been implicated in 12.4 percent of cases, but the majority remain unexplained. Characteristically, the patient will be male (2:1 ratio), in his 50's (30.9 percent), with vague lower back pain (34.2 percent) or possibly flank pain (34.0 percent). Physical examination usually will be unrevealing. The patient's serum chemistry probably will show some degree of azotemia (55.4 percent) and perhaps anemia (13.6 percent). The intravenous pyelogram characteristically shows bilateral hydroureteronephrosis (67.6 percent) or unilateral hydroureteronephrosis (20.3 percent) associated with medial deviation of the ureter due apparently to external compression of the ureter. Methysergide should be discontinued if implicated. Laparotomy for ureteral compression characteristically will reveal a dense, rubbery plaque in the retroperitoneum. Generous frozen section biopsies show fibrosis, usually with some chronic inflammation, suggestive of RPF. Careful inspection of retroperitoneal nodes and liver may reveal the presence of malignancy in 7.9 percent of patients. In the absence of malignancy, the ureters should lyse fairly freely and peristasis may return. If no malignancy is present on permanent sections of biopsy material, the patient can be given a fairly optimistic prognosis (cumulative mortality rate, 9 percent). Suboptimal improvement probably is an indication for steroid therapy and surgical re-exploration may become indicated. In these cases further search for malignancy should be undertaken.
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PMID:The clinical significance of retroperitoneal fibrosis. 84 63

We report two successfully treated cases of ureteral endometriosis. Case 1 is in a 47-year-old female who had a past history of simple hysterectomy and right oophorectomy. Pathological diagnosis was myoma uteri and pelvic endometriosis. Two months later, she visited our clinic for right flank pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. The diagnosis of ureteral endometriosis was made from the past history and clinical features. Danazol therapy started with a daily dose of 400 mg. Sixteen days later, excretory urogram demonstrated complete resolution of the right hydronephrosis. An intravenous pyelography about 1 year after the danazol therapy has indicated no recurrence. Case 2 is in a 35-year-old female who visited our clinic for right lumbar pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. Right ureterocystoneostomy was performed unsuccessfully resulting in endoscopic dilation. Right lower ureter was buried in the dense fibrous tissue approximately 5 cm below the crossing with iliac vessels. The area of obstruction was removed. Histologically, endometriosis was diagnosed. Twenty nine cases of ureteral endometriosis including our two cases were collected from the Japanese literatures and reviewed with respect to the clinical features and treatment.
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PMID:[Two cases of ureteral endometriosis]. 266 Apr 99

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

An 85-year-old female was referred to our hospital with chief complaints of right flank pain and gross hematuria. Ultrasonography demonstrated right hydroureteronephrosis and a thumb head-sized solid mass in the lower third of the right ureter. Cystoscopy revealed papillary tumors near the right ureteral orifice. Under the preoperative diagnosis of right ureteral tumor and bladder tumor, transurethral resection of bladder tumor, right nephroureterectomy and partial cystectomy were performed. The gross specimen of the ureter contained a 5 x 3 x 1 cm, polypoid and smooth-surfaced tumor. The pathological diagnosis of the ureteral tumor was transitional cell carcinoma with inverted proliferation, grade 1 >> grade 2. On the other hand, the bladder tumor was papillary transitional cell carcinoma, grade 1. This is a case in which tumor development showed two different types.
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PMID:[Transitional cell carcinoma of the ureter with inverted proliferation accompanied with papillary bladder tumor: a case report]. 1182 74

We report a case of bilateral synchronous renal cell carcinoma in a 66-year-old-man, who underwent bilateral partial nephrectomy. He visited our hospital, complaining of left flank pain. Drip infusion pyelography showed a left ureteral stone and left hydroureteronephrosis. Computerized tomography revealed bilateral renal tumors. These tumors were small (< 2 cm), so bilateral partial nephrectomy and left ureterolithotomy were performed. The pathological examination showed that all tumors were renal cell carcinoma. No recurrence has been seen nine months after the operation. This is the 12th case in the Japanese literature reported as bilateral partial nephrectomy for bilateral synchronous renal cell carcinoma.
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PMID:[Bilateral partial nephrectomy in a case of bilateral synchronous renal cell carcinoma]. 1272 34

Inflammatory aneurysms represent only 3-10% of all aortoiliac aneurysms and tend to be more common in men. We report a case of a solitary inflammatory aneurysm of the right common iliac artery in a healthy young woman. The patient presented with persistent abdominal and right flank pain. She had no risk factors for vascular disease, except mild hypertension and a strong family history of aneurysm disease. Her work-up demonstrated a 3.0 cm right common iliac artery aneurysm with intramural thrombus, focal calcification, and perianeurysmal inflammation without evidence of systemic atherosclerosis. There was right hydroureteronephrosis secondary to ureteral compression by the inflammatory aneurysm. She underwent open right common iliac artery aneurysmorraphy with polytetrafluoroethylene interposition graft and concomitant ureterolysis without complication. She remains asymptomatic more than 1 year postoperatively with no evidence of additional aneurysm disease, resolution of her hydroureteronephrosis, and normal kidney function. We report a rare case of a solitary inflammatory aneurysm of the right common iliac artery in a healthy young woman, with a review of the current literature on inflammatory aneurysms.
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PMID:Solitary common iliac artery inflammatory aneurysm in a healthy woman: case report and review of the literature. 1618 40

Ureteral tumor is prone to result in lumen obstruction. Villous adenoma is most frequently found in the colon and rectum, seldom in the urinary tract and even more rarely in the ureter or pelvis. Herein, we present a case of bilateral renal stones of more than 10 years' duration with the chief complaint of right flank pain. Obstruction of the right upper ureter with hydroureteronephrosis was observed on sonography, computed tomography and retrograde pyelography. Ureteroscopy revealed papillary tumor obstructing the upper third of the ureter and inducing hydroureteronephrosis with abundant mucoid content. The ureteral tumor proved to be villous adenoma by pathologic examination. It should be noted that ureteral villous adenoma may be related to previous enteric-type metaplastic mucosa or ureteritis glandularis, demonstrates profuse production of mucus, and may eventually undergo malignant transformation.
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PMID:Villous adenoma of the ureter with manifestation of mucus hydroureteronephrosis. 1727 31

A 51-year-old HIV-positive man treated with atazanavir for 9 months presented with anuria following right flank pain. Laboratory examination indicated renal insufficiency, and abdominopelvic computed tomography scanning showed bilateral hydroureteronephrosis, but no stones were visualized. Endoscopic procedures were performed to investigate the causes of ureteral obstruction and, if possible, to insert Double-J stents in the ureters. A yellowish stone composed of pure atazanavir was found at the right ureteral orifice, and retrograde pyelography revealed a filling defect in the left ureter found to be caused by an atazanavir stone. The patient's renal function recovered after removal of these stones.
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PMID:Acute renal failure due to bilateral ureteral stone impaction in an HIV-positive patient. 1863 5

Synthetic mesh has become a popular treatment of pelvic floor relaxation and pelvic organ prolapse, with low complication rates. We describe the case of a woman with unilateral hydroureteronephrosis after a mesh procedure (Gynecare Prolift; Ethicon Women's Health & Urology, Ethicon, Inc., Somerville, New Jersey) successfully treated by neoureterocystostomy. A 39-year-old woman with pelvic organ prolapse underwent the mesh procedure. Two months later, she had left flank pain, and hydroureteronephrosis was diagnosed on the same side despite cystoscopic confirmation of ureteral passage at the first operation. The arm of the mesh was removed surgically, and neoureterocystostomy was performed successfully. Mesh surgery is not without serious complications, and surgeons should bear in mind the possible complications associated with this surgical procedure.
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PMID:Unilateral hydroureteronephrosis after a mesh procedure. 2022 14


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