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

Angiomyolipoma is an uncommon benign tumor of the kidney. The tumor is composed of fat, smooth muscle, and blood vessels. The same pathological entity can appear in two clinically different forms, with or without tuberous sclerosis. We present two cases of renal angiomyolipomas with unusual manifestations. One was associated with tuberous sclerosis and both had the presentation of acute abdomen. Case one presented with epilepsy, angiofibroma, subungual fibroma, periventricular calcification, and bilateral renal angiomyolipomas. Tuberous sclerosis is characterized by these findings. Both cases had spontaneous hemorrhage with hypovolemic shock. Massive hemorrhage resulting in shock is uncommon and the incidence has been estimated to be about 10 per cent. In fact, many angiomyolipomas are clinically occult. The size of the tumor correlates well with the presence or absence of symptoms which include microhematuria, flank pain, hypertension and urinary tract infection. Abdominal CT is the preferred modality for diagnosis of angiomyolipoma. The most important finding is the presence of an intrarenal tumor with fat component which is recognized as a relative low density on CT. Our patients were hospitalized under the impression of angiomyolipoma after the CT study. In addition, the CT defined either the size of the tumor or the extension of the hemorrhage. Although many believe that renal angiography is not sufficient by itself to establish the diagnosis of angiomyolipoma, occasionally it is mandatory in the management of the tumor. The management is decided by two factors, the size of tumor and the clinical presentation. The attitude of management should include conservative treatment with regular follow-up, selective arterial embolization, enucleation, and partial or total nephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Unusual presentations of angiomyolipoma]. 179 71

Transcatheter arterial embolization (TAE) has been widely used in the treatment of tumors as well as other lesions of the kidney. Complications most commonly encountered are post embolization syndrome, such as flank pain, fever, leucocytosis, nausea, vomiting, or ileus. They occur mostly in 24 to 48 hours and its treatment is symptomatic. We experienced a renal abscess developed in a patient of renal tumor with preexisting silent urosepsis. Precise examination of silent infection is recommended as a preprocedure test to avoid such complications.
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PMID:[Renal abscess: complication of transcatheter arterial embolization of renal cell carcinoma]. 261 Jan 81

Though renal cell carcinoma is a fairly common disease, it is extremely rare to encounter a case providing a resected mass as large as over 2,000 g in weight. We report a case in which a giant 2,200 g tumor was resected after renal arterial embolization and interferon treatment for reduction of its size. A forty-three-year-old woman was first seen at a certain hospital with a chief complaint of fever and right flank pain. Under suspicion of right renal tumor, nephrectomy by extraperitoneal flank incision was attempted. However, the tumor was too large to be resected. After transfer to our department, she was treated by renal arterial embolization with absolute ethanol and steel coil and by the administration of interferon (rIFN-alpha A). As the tumor shrank to 77% of its original size on CT measurements and became mobile, transperitoneal nephrectomy was performed. The resected mass was as large as 12 x 12 x 21 cm. Pathologically, it was a clear cell type tumor showing mucinous degeneration and hyaline degeneration of tumor cells. Interferon used amounted to as high as 864 x 10(6) units, but no particular side effect occurred. No recurrence has been detected so far.
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PMID:[Giant renal cell carcinoma: a case report]. 280 77

Renal arterial embolization is often used in the treatment of patients with renal cell carcinoma, either preoperatively to facilitate nephrectomy or as palliative therapy in advanced cases. Eighteen patients (18/58; 31%) underwent renal arterial embolization in our department since 1979, initial 10 cases with Gelfoam and steel coil (group G) and recent 8 cases with absolute ethanol (group A). Clinical studies of daily changes of symptoms and blood chemistry in both groups after embolization were compared and the results were as follows: Severe flank pain was noted immediately after embolization but thereafter well controlled without analgesics in group A. The patients in group G experienced no pain during the procedure of embolization but have had moderate flank pain of two or three days' duration with nausea and/or vomiting and required surgical procedure within a few days after embolization. Post embolization fever in group A was described as higher than that in group G significantly. Leukocytosis was noted to be persistent for up to seven days and blood chemistry showed transient marked elevations of GOT, GPT and LDH immediately after the procedure without significant value in both groups. Embolization to advanced tumor with many parasitic vessels or massive local invasion may not always be available for remaining of viable-appearing tumor cells in venous lumen, as if palliative treatment. Absolute ethanol may be more useful as the embolizing substance than Gelfoam and steel coil by reason of producing wide severe infarction of diseased kidney. Broad marked infarction due to renal arterial embolization may make pathological diagnosis difficult. Immunological effects of renal arterial embolization were not observed in short term patients survival.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Renal arterial embolization for renal cell carcinoma]. 402 78

Transcatheter arterial embolization (TAE) has been commonly used in the treatment of renal cancer. Postembolization syndrome consisting of fever, flank pain and gastrointestinal symptoms is encountered in almost every case. We report a case of E. coli-induced retroperitoneal abscess accompanied by intraabdominal free air which developed three weeks after TAE in a 59-year-old woman with T4N0M0 renal cancer. No fistula between abscess and gastrointestinal tract could be demonstrated by gastrofiberscopy and barium enema. Urine culture just before TAE should be examined to avoid such a complication.
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PMID:[Retroperitoneal abscess formation accompanied by intraabdominal free air, a rare complication of transcatheter arterial embolization of renal tumor: a case report]. 874

Congenital arteriovenous malformation (AVM) of the kidney is a rare condition. Rupture of an AVM in the kidney may cause hematuria, flank pain, and urinary retention due to clots. We report 2 cases of congenital renal AVM. Both were treated with transcatheter renal arterial embolization. The signs and symptoms disappeared after embolization. On follow-up, renal function testing with a DMSA scan revealed only focal loss of renal cortical function. The clinical courses of 2 cases are reported and the literature is reviewed.
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PMID:Congenital renal arteriovenous malformations: two cases report. 960 76

A 74-year-old man with severe right flank pain and hypochondralgia, was admitted to a hospital where he was found to have an abnormality of the right kidney on computed tomographic (CT) scan. He was referred to our department for further examination and treatment on the next day. Spontaneous rupture of the right renal cell carcinoma was mostly suspected from preoperative clinical findings obtained by ultrasonography. CT scan and angiography. Extravasation was not recognized on angiography. We chose emergent transcatheter arterial embolization prior to radical nephrectomy. The surgical specimen contained a solid and yellowish mass invading into the renal pelvis. Subcapsular rupture was identified. Histopathological diagnosis was renal cell carcinoma consisting of invasive growth of highly atypical epithelial cells with a sarcomatous pattern, and the tumor cells were present in the renal pelvis. He died of lung cancer 26 months after the operation.
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PMID:[Spontaneous rupture of renal cell carcinoma: a case report]. 1036 45

We present a case of spontaneous rupture of bilateral renal angiomyolipoma (AML) with tuberous sclerosis. A 46-year-old woman was admitted with sudden onset of severe left flank pain. She had been diagnosed to have bilateral AML with tuberous sclerosis 15 years earlier. Four years after the initial diagnosis, spontaneous rupture of right renal AML occurred and right renal embolization of the right renal artery was performed. The treatment for the left renal AML was not performed. Eleven years later in 2000, spontaneous rupture of contralateral renal AML occurred and left renal embolization of the left renal artery was performed. We evaluated the efficacy of selective arterial embolization in right AML and the change of the tumor size during a 10-year follow up after embolization. The right AML had decreased 86% in 11 years. Selective arterial embolization is an effective and safe treatment for AML. We evaluated the natural history of left AML and calculated the doubling time to be about 1,370 days for the first period of 4 years and about 2,075 days for the second period of 11 years. Although the growth change was very slow, we should observe the tumors carefully on computed tomography or ultrasound to prevent life-threatening hemorrhage.
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PMID:[Spontaneous rupture of renal angiomyolipoma with tuberous sclerosis during long-term follow-up: a case report]. 1169 3

Kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD) usually continue to increase in size, even after patients begin dialysis therapy, and the mass effects may lead to severe complications. Such external conventional therapies as surgical and laparoscopic procedures have not yielded satisfactory results. Because kidneys in patients with ADPKD usually are supplied by well-developed arteries, we attempted renal contraction therapy in patients with ADPKD by renal transcatheter arterial embolization (TAE) using intravascular coils. After obtaining informed consent, we selected anuric patients on dialysis therapy with markedly distended abdomens or macroscopic hematuria. Between October 1996 and December 2000, a total of 64 patients were treated. Renal size, abdominal circumference, dry weight, hematocrit, and insulin-like growth factor-I were measured before TAE and 3, 6, and 12 months after TAE. Renal sizes decreased to 73.8% +/- 12.0%, 61.7% +/- 14.7%, and 53.4% +/- 11.6% of preinterventional values at 3, 6, and 12 months after therapy, respectively (P < 0.0001). Abdominal circumference and dry weight were significantly decreased at 3, 6, and 12 months (P < 0.0001) compared with baseline values before therapy. Hematocrits increased sequentially after 3, 6, and 12 months (P < 0.0001). Levels of insulin-like growth factor-I an index of nutritional status, significantly increased at 3, 6, and 12 months compared with the baseline value (P < 0.001). This therapy was effective for all patients. Serious complications were not seen after this treatment, although such minor complications as fever and flank pain were observed within the first week after the procedure. Our internal treatment with TAE is a safe and effective procedure that has resulted in improvement in the quality of life and nutritional status of patients with ADPKD.
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PMID:Renal contraction therapy for enlarged polycystic kidneys by transcatheter arterial embolization in hemodialysis patients. 1187 76

Anaerobiospirillum succiniciproducens is rarely associated with bacteremia but results in significant mortality. Almost all reported bacteremia cases have occurred in immunocompromised hosts, such as those with alcoholic liver disease, atherosclerosis, recent surgery, malignancies, or acquired immunodeficiency syndrome. We describe here, to our knowledge, the first clinical evidence for A succiniciproducens bacteremia in a healthy man. A 61-year-old man had fallen from a roof and was admitted to our emergency department with severe left flank pain without an external wound. He was given transcatheter arterial embolization for the left kidney injury on the same day, and his condition stabilized. Four days after admission, he had fever without gastrointestinal signs and symptoms. Spiral-shaped, gram-negative anaerobic bacteria were isolated from 2 sets of blood cultures, and the oxidase and catalase test results were negative. The isolated bacteria were different from the Campylobacter spp. On the next day, the bacteria were confirmed as A succiniciproducens by 16S rRNA sequencing. The patient responded to sulbactam/ampicillin. On day 13, the patient was discharged with a 7-day prescription for oral amoxicillin/clavulanate. Six months after admission, the patient was free of recurrent infection. A succiniciproducens bacteremia can occur in healthy adults. When large gram-negative spiral-shaped bacteria are detected, this bacterial species should be considered and differentiated from the Campylobacter spp because A succiniciproducens is often resistant to macrolide antibiotics.
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PMID:Anaerobiospirillum succiniciproducens-induced bacteremia in a healthy man. 2444 May 90


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