Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Some patients with the loin pain/hematuria syndrome suffer incapacitating flank pain. No effective therapy has been reported. Uncertainty persists concerning the authenticity of the pain and the role of surgery in treatment. Forty-six patients with loin pain/hematuria syndrome and intractable pain were evaluated following treatment either by renal autotransplantation (30 patients, 10 bilaterally) or by renal denervation (20 patients, four bilaterally) over a 13-year period. All patients had concomitant renal nerve excision and ligation and capsulotomy. There were 37 (80%) women and nine men aged 18 to 61 years (mean age, 33 years). Excretion urography and angiography were normal in all patients. Nineteen of 25 (76%) patients in whom renal autotransplantation was successfully accomplished and who completed a follow-up questionnaire were free of pain, including eight of 10 with bilateral procedures. The follow-up periods ranged from 1 to 13 years (mean, 8.4 years). Six patients have been free of pain for 10 to 13 years. Of 18 patients treated with renal neurectomy who were available for follow-up examination, 12 (67%) developed recurrent renal pain, including four who had pain relief on the other side following previous renal autotransplantation. The follow-up period for these patients ranged from 6 to 9.9 years (mean, 8.0 years). Three of four patients with recurrent renal pain following neurectomy were treated successfully by renal autotransplantation. The loin pain/hematuria syndrome is a rare cause of incapacitation, predominantly of relatively young females. The pain of the syndrome is organic. Renal autotransplantation achieves pain relief in three quarters of patients, but the procedure is often (30%) required bilaterally and has significant complications. Renal neurectomy is followed by an excessive incidence of recurrent renal pain.
 ...
PMID:Evaluation of the loin pain/hematuria syndrome treated by renal autotransplantation or radical renal neurectomy. 970 4

The case of a patient with acute onset of flank pain and hematuria is presented. Initial therapy was directed toward relief of pain believed to be caused by renal colic. It was not until the patient developed atypical features that the true diagnosis, ruptured renal angiomyolipoma, was discovered. The case and discussion emphasize the need to carefully consider a complete differential diagnosis when evaluating patients with flank pain and hematuria who have atypical clinical features or an atypical course.
 ...
PMID:Ruptured renal angiomyolipoma presenting as renal colic. 982 40

Adrenal gland metastasis is often observed during the clinical course of patients with lung cancer. However, treatment of adrenal gland metastasis is seldom considered because of the systemic spread of the disease. Treatment with curative intent is very rare, but palliative treatment may sometimes be considered when symptoms such as flank pain are observed. Three cases of adrenal gland metastasis were reported. Two of them received surgery for lung cancer and developed a sole metastasis of the adrenal gland. Case 1 developed a sole left adrenal gland metastasis with left flank pain 14 months after surgery for large cell carcinoma of the lung. Curative radiotherapy after intra-arterial chemotherapy was given. A good response was obtained, and he has been alive for 2 years and 9 months. Case 2 developed a right adrenal gland metastasis after radiotherapy for brain metastasis, after having received right upper lobectomy because of SCLC. The increase in the size of the right adrenal gland led us to treat the lesion before symptoms developed. Radiotherapy was given on an outpatient basis. Case 3, who was previously treated with chemoradiotherapy for SCLC, developed brain, liver, and bilateral adrenal gland metastasis. Huge adrenal gland metastases displaced the pancreas and caused severe pain with the increase in serum amylase level. Concurrent radiotherapy with systemic chemotherapy was given and remarkable shrinkage of the adrenal gland metastases was obtained together with pain relief. Cases 2 and 3 died after 8 and 4 months, respectively. In some cases, radiotherapy for adrenal gland metastasis is a good palliative therapy even in the advanced stage patients. Radiotherapy can sometimes curatively treat adrenal metastasis from NSCLC, as in our Case 1, in which adrenalectomy appeared difficult at the time of recurrence.
 ...
PMID:Radiotherapy for adrenal gland metastasis from lung cancer: report of three cases. 1037 56

Schwannomas (also known as Neurilemomas or Neurinomas) are benign tumors of the nervous system that originate in the neural sheath and most commonly occur as solitary encapsulated subcutaneous tumors in otherwise healthy individuals. When they present as multiple tumors, they are histologically indistinguishable from the solitary tumors and, in such a case, they may be associated with neurofibromatosis 2 (NF2) in which the sensory roots of the cranial and spinal nerves are affected more often than the motor roots and the hallmark tumor of which is a vestibular schwannoma (also known as acoustic neuroma). They also may exist as a distinct clinical entity without any stigmata of neurofibromatosis known as schwannomatosis. Generally, schwannomas are less than 5 cm in diameter but sizes greater than 14 cm have been reported. They present as slow growing masses and may present with pain or neurological symptoms. Here we report a patient with sympathetic schwannoma who presented with right flank pain.
 ...
PMID:Sympathetic schwannoma: a case report. 1046 9

Intravenous urography (IVU) is a useful radiographic study in the detection of renal and ureteral calculi. However, it is time consuming, expensive, and exposes the patient to i.v. contrast and radiation. To determine the impact of utilizing IVU less for the detection of renal calculi, criteria for ordering IVU in the emergency department (ED) were evaluated, and patients with high probability of positive IVU were identified. Variables included presence of acute flank pain with haematuria, prior history of renal calculus, degree of haematuria, and uncontrolled pain. We reviewed patients presenting with acute flank and abdominal pain with haematuria from May 1995 to May 1996 at a large urban university hospital. Charts were abstracted for prior history, reason for ordering IVU, time in the ED, laboratory results, IVU result, final diagnosis, and disposition. Data was analysed with Student's t-test, Wilcoxon rank-sum and receiver operating characteristic (ROC) analysis. A total of 302 patients were identified, and 185 underwent IVU during the study period. For patients with prior history of renal calculi 82% had positive IVU (sensitivity 51%, specificity 87%). For patients with both acute flank pain and haematuria, 92% had a positive IVU (sensitivity 93%, specificity 43%), and 19% of patients with abdominal pain of unclear aetiology with haematuria had a positive IVU. All patients with uncontrolled pain had evidence of high-grade obstruction on IVU. Degree of haematuria was not predictive of a positive IVU from ROC curve derivation. IVU is a useful study in the ED but may be overutilized, leading to lengthy patient stays. The combined objective findings of acute flank pain and haematuria are sensitive, and prior history is specific in identifying patients with renal calculi. Degree of haematuria was not useful in predicting renal calculi. By utilizing the criteria of acute flank pain and haematuria as a decision aid, 66% of all IVUs ordered could have been avoided.
 ...
PMID:Intravenous urography in the emergency department: when do we need it? 1046 57

A 72-year-old man underwent total cystectomy with single stoma cutaneous ureterostomy for the treatment of transitional cell carcinoma of the bladder. The patient came to the outpatient clinic every 2 weeks to exchange ureteral catheters. Six months after the operation, he was admitted to our hospital again due to edema of bilateral legs, fever, and loss of appetite. The patient had metastasis of intrapelvic and paraaortic lymph nodes associated with cachexia, and was given intravenous hyperalimentation and treatment to control pain. Suddenly, he complained of left flank pain. When the ureteral catheter was removed, massive bleeding occurred from the stomal orifice. A fistula between the artery and ureter was suspected. Six days later, the patient died due to acute renal failure. After his death, retrograde ureterography was performed to confirm the fistula. A fistula was found between the left common iliac artery and left ureter.
 ...
PMID:[A fistula between the common iliac artery and ureter following cutaneous ureterostomy: a case report]. 1050 Sep 59

Although a transhiatal bilateral splanchnicotomy (TBS) has many advantages, it has not been widely employed as an effective minimal invasive therapy for intractable supramesenteric pain. Furthermore, the effects of TBS have not yet been clearly evaluated. Between 1995 and 1997, TBS was performed on 11 patients with intractable epigastric and/or flank pain due to unresectable pancreatic cancer, chronic pancreatitis, or an unknown cause. The effect of TBS on the pain was evaluated using a novel simple pain score and pain reduction percentage scaled on the basis of the medication and the judgments by patients themselves, respectively. The detection and cutting of the bilateral great splanchnic nerves were easily performed in all of the patients using common flexible chondrocostal retractors. The evaluation of the TBS effect using the pain score clearly demonstrated the early and late mean postoperative pain score (1.1 +/- 0.9 and 1.4 +/- 1.2: mean +/- SD) to be significantly (P = 0.0002 and P = 0.002, respectively) lower than the preoperative pain score (3.5 +/- 0.7). Furthermore, the mean postoperative pain reduction percentage (85% +/- 13%) evaluated by those patients was also significantly different (P < 0.0001). The present study showed no significant complications for TBS, except for minor complications such as the transient fall of blood pressure and reparable pleural damage. Interestingly, a long-term follow-up revealed that no complications related to the splanchnicotomy were observed. These results indicate that TBS is a useful treatment for patients with intractable supramesenteric pain caused by cancer as well as benign diseases.
 ...
PMID:Clinical evaluation of transhiatal bilateral splanchnicotomy for patients with intractable supramesenteric pain. 1055 30

The aim of this study was to evaluate the effectiveness of ureteral stent placement in diagnosing ureteropelvic junction (UPJ) obstruction in patients with negative or equivocal radiographic/nuclear studies and to assess relief of symptoms following definitive surgical procedures to relieve the obstruction. Patients undergoing ureteral stent placements performed by two attending urologists over an 18-month period were reviewed. All patients with equivocal or negative radiographic evaluations for ureteral obstruction in whom the stent was placed for diagnostic purposes were selected. Preoperative and postoperative information was obtained from the medical record or by telephone interview. Five patients were found who had equivocal radiographic studies along with symptoms of flank pain and who underwent diagnostic stent placement. All patients were female (average age 40 years, range 20-52). All had pain relief following stent placement and, on this basis, underwent an operative procedure to remove the presumed ureteral obstruction. Three underwent Acucise endopyelotomy, one had laparoscopic resection of the right ovarian vein, and one underwent nephrectomy. The average preoperative creatinine level was 0.9 mg/dL (range 0.8-1.0), and the average postoperative creatinine level was 1.0 mg/dL (range 0.9-1.1). All patients had relief of flank pain at a mean of 17 months following the surgical procedure. Relief of pain following stent placement in patients with clinical suspicion of ureteral obstruction portends a favorable outcome from procedures to relieve the presumed obstruction. In unusual cases where ureteral obstruction is suspected despite negative or equivocal radiographic findings, diagnostic stent placement appears to be useful.
 ...
PMID:Stent placement for the diagnosis of upper tract obstruction. 1059 Dec 60

Autosomal dominant polycystic kidney disease (ADPKD) is often characterized by end-stage renal disease (ESRD) and problems including pain, hematuria, and infection. Open nephrectomy is curative; however, the morbidity of the procedure is considerable. Between 1995 and 1998, 11 laparoscopic nephrectomies were performed on nine symptomatic patients (five men and four women) with ESRD and ADPKD. Two patients underwent a staged bilateral laparoscopic nephrectomy. All patients presented with abdominal or flank pain and an abdominal mass. Other clinical problems included hypertension in eight patients, urinary tract infections in two patients, and gross hematuria in one patient. Seven patients were receiving long-term dialysis treatment, and two patients had undergone prior renal transplantation. Patients were evaluated for preoperative and postoperative pain, analgesic use, hospital course, and convalescence. The overall average operative time was 6.3 hours, with an average estimated blood loss of 153 mL. Eight nephrectomy specimens were removed by morcellation, and three specimens were removed intact through a 7- to 12-cm incision. The average hospital stay was 3 days, and the average time to normal activity was 5 weeks. With a mean follow-up of 31 months, all nine patients reported elimination of their preoperative pain based on a pain analogue score. Six major and two minor complications occurred, including blood transfusion, a vena cavotomy, splenic cyanosis, pulmonary embolism, clotted arteriovenous fistula, and brachial plexus injury. Incisional hernias occurred in two of the three patients who underwent open removal. One patient noted improvement, and two patients noted resolution of their hypertension postoperatively. Laparoscopic nephrectomy in patients with ADPKD and ESRD offers an effective alternative to open nephrectomy to manage renal-related pain. This procedure provides the benefits of minimal intraoperative blood loss, minimal postoperative pain, brief hospital stay, and rapid convalescence.
 ...
PMID:Laparoscopic nephrectomy in patients with end-stage renal disease and autosomal dominant polycystic kidney disease. 1073 3

Mass lesions in the iliopsoas compartment (MLIPC) are uncommon in patients in departments of medicine and their incidence and etiologies are unclear. In a prospective study we diagnosed various MLIPCs in 7 patients during a 10-year period, representing 0.03% of admissions. Symptoms included abdominal or flank pain (4 cases), pain along the thigh (5), diminished psoas muscle strength (2), fever (2), and hypotension (1). MLIPC was suspected on clinical grounds in 5 cases. In all cases the diagnosis was established by computed tomography (CT). Tissue was sampled by needle biopsy in 4 and on surgery in 1. MLIPCs were caused by hemorrhage (2), infection (2), neoplasia (2) and inflammatory mass (1). Often MLIPCs are life-threatening so their timely diagnosis by early CT scan is important.
 ...
PMID:[Space-occupying lesions in the iliopsoas space: a challenge in the Department of Internal Medicine]. 1091 77


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>