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

Complications resulting from persistent and repeated urinary tract infections (UTIs) account for nearly 1 million hospital admissions annually. Cystitis, a localized bladder infection occurring in the lower tract, is recognized by a symptom complex of dysuria, frequency, urgency, and suprapubic tenderness; pyelonephritis, which refers to upper tract infection of the kidneys, classically manifests with flank pain and systemic as well as cystitis signs. An empiric 3-day antibiotic regimen has been shown to be more than 95% effective in curing cystitis. But for a subgroup of patients, a relapse of "cystitis" within 4 weeks can signal a subclinical, "silent," pyelonephritis. A 14-day course of antibiotics is indicated to treat the recurrent UTI. Follow-up urinalysis and urine cultures are then repeated 2 and 4 weeks after therapy. If symptoms and/or bacteriuria are again documented with the same organism, subclinical pyelonephritis is presumed; a prolonged 6-week course of antibiotics is then warranted to prevent prolonged problems and complications associated with UTIs. When the problem is reinfection with a microorganism different from that responsible for the last infection, short-course therapy for 3 days may be prescribed for each episode. When reinfection occurs more frequently than 2 to 3 times a year, however, antibiotic prophylaxis to prevent reinfections is warranted.
Medscape Womens Health 1996 Sep
PMID:Can a Silent Kidney Infection or Genetic Predisposition Underlie Recurrent UTIs? 974 44

A case of renal cell carcinoma that was discovered in a patient with typical acute pyelonephritis is reported. A 62-year-old woman admitted with fever and right flank pain, was diagnosed as having acute pyelonephritis. Intravenous urography showed a compressed renal pelvis and mild dilated calyces, suggesting the existence of a tumor. Computed tomography revealed a parapelvic tumor 6 cm in diameter and a small low-density area separated from the tumor in the renal parenchyma. Selective renal arteriography revealed a typical renal cell carcinoma lesion. The patient underwent right radical nephrectomy, and her postoperative course was uneventful. She has remained free of disease for 7 months.
Hinyokika Kiyo 1998 Sep
PMID:[Renal cell carcinoma discovered in a patient with typical acute pyelonephritis: a case report]. 980 69

A 66-year-old man presented with right flank pain and macroscopic hematuria. Abdominal radiographs and computed tomography revealed a right pyelocalyceal diverticulum with milk of calcium and a soft tissue mass inside it. Other examinations, including positive urine cytology and negative random bladder biopsies, suggested a malignant tumor of the pyelocalyceal diverticulum. The patient underwent right nephroureterectomy. Histopathological examination revealed grade 3 transitional cell carcinoma. This is the first case of transitional cell carcinoma and milk of calcium coexisting in the same pyelocalyceal diverticulum.
Hinyokika Kiyo 1998 Sep
PMID:[A case of transitional cell carcinoma and milk of calcium in a pyelocalyceal diverticulum]. 980 70

We present our experience with transabdominal ultrasonographic diagnosis of ureteral tumors. During the years 1989 to 1998, 16 patients were diagnosed as having ureteral tumors. These patients were referred for sonographic examination for evaluation of hematuria (seven patients) or flank pain (four patients) or for follow-up screening in patients who were asymptomatic but at high risk for transitional cell carcinoma because of known past bladder tumor (five patients). Ten of these patients underwent intravenous urography examination, three patients had retrograde pyelography, and 11 patients underwent CT scanning. Ultrasonography revealed the ureteral tumors in all 16 patients, which appeared as hypoechoic intraluminal soft tissue. Three tumors were localized in the upper ureter, four in the middle ureter, and nine in the distal ureter. The degree of ureterohydronephrosis was minimal (two cases), mild (five cases), moderate (eight cases), or severe (one case). Eleven tumors caused local widening of the ureteral diameter. On intravenous urography, four patients had a nonfunctioning kidney, three patients had unexplained ureterohydronephrosis, and three patients showed ureteral filling defects, of which only two had irregular contours. On retrograde pyelography, two patients had filling defects (one of which with smooth margins), and one had a truncated ureter. On CT the tumor was clearly demonstrated in only seven patients. We found that ultrasonography can be a useful diagnostic tool in the workup of ureteral tumors.
J Ultrasound Med 1999 Sep
PMID:Sonographic diagnosis of ureteral tumors. 1047 73

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.
Radiol Clin North Am 1999 Sep
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.
Urologe A 1999 Sep
PMID:[Ureteral stent placement in hydronephrosis during pregnancy]. 1050 8

We report our clinical experience with magnetic resonance urography in 13 patients. This noninvasive relatively new application of magnetic resonance to initial radiologic evaluation of patients with acute flank pain offers valuable diagnostic information and may provide additional support in defining the need for possible further therapeutic intervention in selected cases.
Tech Urol 1999 Sep
PMID:Magnetic resonance urography in the evaluation of acute flank pain. 1052 61

A case of pyonephrosis with high levels of serum CA19-9 antigen is reported. A 71-year-old woman was admitted with right flank pain. Computed tomography and ultrasonography showed severe hydronephrosis and hydroureter due to a right ureter stone. Laboratory data revealed a high level of serum CA19-9. However, no tumor was found in the pancreas, gallbladder, liver, gastrointenstinal tract or genitourinary tract. Drip infusion pyelography showed a non-functioning pattern of right kidney. Therefore, right nephroureterectomy was performed for right pyonephrosis. Histological examination revealed chronic inflammation. Malignant cells were not seen in the resected specimen. The serum CA19-9 levels before and after operation were 102.9 U/ml and 24 U/ml, respectively, being normal after the operation. Immunohistochemical examination revealed the presence of CA19-9 antigen in the urethelium, indicating its expression in the specimen. To our knowledge this might be the first case of pyonephrosis associated with high levels of serum CA19-9 antigen.
Hinyokika Kiyo 1999 Sep
PMID:[A case of pyonephrosis caused by ureteral stones with elevated serum levels of CA19-9]. 1054 Jul 10

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?
J Radiol 2000 Sep
PMID:[Urolithiasis, CT and lithotripsy guidelines]. 1099 90

Extraosseous Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) is a rare soft tissue tumor of childhood usually found in the extremities. The authors present the case of a 17-year-old girl who presented with right flank pain and hematuria and during operation was found to have a right ureteral mass. The histopathologic, immunohistochemical, ultrastructural, and cytogenetic characteristics of the excised mass were consistent with extraosseous ES/PNET. This is the first known reported case of extraosseous ES/ PNET of the ureter. The pathologic features and clinical management of this case, as well as a review of the literature, are presented.
J Pediatr Surg 2000 Sep
PMID:Ewing's sarcoma/primitive neuroectodermal tumor of the ureter: a case report and review of the literature. 1099 98


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