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 26-year-old female visited our hospital complaining left flank pain and macroscopic hematuria. She had been suffering ulcerative colitis and administered salazosulphapyridine and predonisolone from 17-year-old. Intravenous urography showed radiolucent multiple stones in the left renal pelvis. Three sessions of extracorporeal shock wave lithotripsy were performed after ureteral stenting. Although disintegration and discharge of the stones were satisfactory, bladder stone induced by ureteral stent was complicated. The extracted bladder stone showed a yellowish brown color and the surface was granular shape. Composition of the stone was acetyl sulphapyridine which was a metabolite of salazosulphapyridine. After maintenance of the urinary pH ranges between 6.5 and 7.5 by medication of sodium bicarbonate, the patient remains free of stone for 3 years. Drug induced urolithiasis originated from salazosulphapyridine is extremely rare. Satisfactory oral fluid intake and urinary alkalization are important for prevention of sulpha drugs calculi of urinary tract.
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PMID:[A case of drug induced urolithiasis composed of acetyl sulphapyridine associated with ulcerative colitis]. 1034 5

Urolithiasis is a common medical problem. The diagnosis of this entity in the setting of acute flank pain presents an interesting challenge to the radiologist. Unenhanced helical CT has recently entered the fray and has quickly become the imaging study of choice when evaluating patients with acute flank pain and suspected ureterolithiasis. The nature and origin of ureteral stones and the pathophysiology of ureteral obstruction provide a basis for understanding the imaging findings in these patients.
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PMID:Helical CT of urinary tract stones. Epidemiology, origin, pathophysiology, diagnosis, and management. 1049 78

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 retrospective review was performed of the records of 85 children with urinary-tract calculi evaluated and treated during a 12-year period. The study evaluated the patients' age, sex, initial complaints, etiology, relevant pathological factors, stone location, mode of treatment, and stone analysis. There were 68 boys and 17 girls, a ratio of 4:1. Patient age ranged from 10 months to 16 years (average 8.2 years). Flank pain was the most common manifestation. Seventy patients had calculi in the upper urinary tract and 31 in the lower urinary tract; 16 had stones in more than one site and 15 had bilateral stones. Hypercalciuria was the most common metabolic disorder. Most patients underwent open surgical procedures for removal of their calculi; 5 stones were successfully removed endoscopically. In 3 cases, the stones passed spontaneously. Calcium oxalate and calcium phosphate stones were present in 32 cases, struvite in 5, cystine in 2, and uric acid in 1 Urolithiasis is still one of the most common pediatric urologic problems in Turkey, but as living standards improve, the incidence of the disease has tended to decline in recent years. Anatomic anomalies and metabolic disorders are of great importance in the etiology of stone disease.
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PMID:Urolithiasis in childhood. 1066 38

3% of the population experiences a flank pain during its lifetime. A flank pain is explained by calculus disease in more than 70% of the cases. Since the introduction of spiral CT and lithotripsy the work up of urolithiasis has changed. Many tests and treatment are available: KUB, IVP, ultrasound with color Doppler, CT and MR urography for diagnosis; lithotripsy, stenting or open surgery for treatment. The emergency practitioner, the radiologist and the urologist should answer three questions that will be reviewed in this paper: Is the acute flank pain caused by urolithiasis? Will calculus be spontaneously discharged? Is lithotripsy indicated?
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PMID:[Urolithiasis, CT and lithotripsy guidelines]. 1099 90

Indinavir sulfate is a protease inhibitor that has been found to be extremely effective in increasing CD4+ cell counts and in decreasing HIV-RNA titers in patients with HIV and AIDS. However, patients receiving indinavir also have been noted to have a significant risk for developing urolithiasis. Published reports of indinavir urolithiasis estimate its incidence at between 4 and 13%. Indinavir has a high urinary excretion with poor solubility in a physiologic pH solution. Consequently, patients develop urinary stones that are principally composed of indinavir or of a mixture of indinavir and other substances, such as calcium oxalate. Similar to other forms of urolithiasis, acute flank pain and hematuria are the typical symptoms of indinavir urolithiasis. Indinavir urolithiasis is unique in that computed tomography, which was once thought to be efficacious in identifying all urinary calculi, is not useful in imaging stones that are composed of pure indinavir. Indinavir urolithiasis generally responds to a conservative regimen of hydration, pain control, and the temporary discontinuation of the medication. Only a minority of patients need surgical intervention. Approximately 10% of patients ultimately need to discontinue indinavir therapy altogether. Indinavir is an antiviral agent that has a significant role in the treatment of AIDS. Although urolithiasis is a significant side effect of indinavir use, limiting its clinical application is not the answer. Rather, physicians need to know more about indinavir urolithiasis to help their patients cope with its potential complications.
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PMID:Indinavir urolithiasis. 1114 25

Two cases of renal pelvis rupture caused by urolithiasis are reported. The first case was in a 62-year-old male who had left flank pain. Urological examination including drip infusion pyelography (DIP) and abdominal computed tomography (CT) revealed a spontaneous rupture of the left renal pelvis. The rupture was assumed to have been caused by a small ureteral stone. The stone passed spontaneously, and the extravasation disappeared with conservative therapy. The second case was in a 84-year-old male who was admitted with high fever. Urological examination including DIP and abdominal CT showed a suspected rupture of the left renal pelvis due to a renal stone at the ureteropelvic junction. Percutaneous nephrostomy was performed and antegrade pyelography showed extravasation from the left renal pelvis. Extravasation disappeared on the 12th postoperative day. Extracorporeal shock wave lithotripsy was performed three times. The renal stone was completely discharged and the nephrostomy tube was removed successfully.
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PMID:[Rupture of renal pelvis due to urolithiasis: report of two cases]. 1123 20

A 14-year-old boy complained of left flank pain. He had been given high-dose corticosteroid therapy for chronic inflammatory demyelinating polyneuropathy (CIDP). Retrograde pyelography revealed irregular defects at the left ureteropelvic junction (UPJ), and ureteroscopy demonstrated ureteral polyp. The polyp was removed and histologically diagnosed as fibroepithelial polyp. Hypercalciuria due to the corticosteroids and bedridden was assumed to have been a causative factor in the stone formation. To our knowledge, this is the first report of a ureteral fibroepithelial polyp in children associated with urolithiasis, and associated with CIDP.
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PMID:Ureteral fibroepithelial polyp associated with urolithiasis induced by steroid therapy in a child: a case report. 1157

Despite of the diagnostic potential of conventional CT (CCT), limitations being inherent in this technology reduce its diagnostic confidence and limit clinical CT applications as 3D imaging. Helical CT (HCT) has far overcome the limitations of CCT and has become the standard CT technology. After a short overview on the technique of HCT and its advantages over CCT, the impact of HCT on the detection of disorders of the urinary organs is discussed. Due to the high quality of 3D reconstructions, vessels are visualized free of artefacts resulting in a dramatic improvement and acceptance of CT angiography, which has become a clinically important examination in the evaluation of obstructive renal artery disease. Fast HCT provides a precise assessment of the three phases of the nephrogram and it is a prerequisite for an improved depiction of abnormal vascular perfusion and impaired tubule transit of contrast material. Helical CT enables an improved characterization of cystic mass lesions reducing the diagnosis of indeterminate masses and thus facilitating a better therapeutic management. The diagnosis of renal cell carcinomas (RCC) has improved due to an increased sensitivity in detecting small RCCs, and an increased specificity in the diagnosis of neoplastic lesions. Improved staging of RCCs is the result of accurate assessment of venous tumour extension. When planning nephron-sparing surgery 3D display of the renal tumour helps to determine the resectability of the mass depicting its relation to major renal vessels and the renal collecting system. In the evaluation of renal trauma HCT provides shorter scanning time and thus fewer artefacts in the examination of traumatized patients who cannot cooperate adequately. Three-dimensional postprocessing modalities allow the assessment of the renal vascular pedicel by CT angiography and improve the demonstration of complex lacerations of the renal parenchyma. In the evaluation of the upper urinary tract unenhanced HCT has become the imaging method of choice in the diagnosis and differential diagnosis of acute flank pain since it is highly sensitive and specific in detecting calculus disease. Unenhanced HCT may furthermore demonstrate causes of flank pain unrelated to urolithiasis. Gapless volume scanning and improved resolution in the z-axis during the excretory phase enables improved visualization of the renal collecting systems and ureters, resulting in a better demonstration of intraluminal and extraluminal pathology.
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PMID:Helical CT of the urinary organs. 1187 Apr 72

A 72-year-old non-diabetic uremic woman underwent right nephrectomy for urolithiasis at the age of 50. Because pyuria, fever, chilliness and left flank pain developed during preparing for arteriovenous fistula, she was admitted to National Cheng Kung University Hospital. Renal cell carcinoma (RCC) complicated with emphysematous pyelonephritis (EPN) was diagnosed and immediately treated with antibiotics and CT-guided percutaneous catheter drainage. Cultures of pus and blood yielded Escherichia coli. She received left radical nephrectomy later for the control of persistent sepsis and removal of left renal tumor. The pathology of the tumor was composed of a glandular arrangement of granular cells with the occasional atypism, and renal parenchyma had been totally replaced by RCC. The non-tumor part of the kidney showed chronic pyelonephritis. Five months later, multiple metastases developed. We reported this first uremic case with EPN and RCC, but without diabetes mellitus and urinary tract obstruction. The gas formation may be due to large RCC, which caused impaired tissue perfusion and E. coli infection.
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PMID:Renal cell carcinoma complicated by emphysematous pyelonephritis in a non-diabetic patient with renal failure. 1218 10


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