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 52-year-old man was admitted to the General Surgical Service, with acute onset of left back and flank pain. Two weeks prior to admission he had been subjected to a 3G to 4G acceleration in an ejection seat training simulator. On the day of admission, he had performed a 100 yard swim in flight gear following a seven foot jump into water. He denied any injury during the above exercises or any other trauma. A falling hematocrit was demonstrated by serial determinations and a computerized tomography scan revealed a left retroperitoneal hematoma with normal bilateral renal function and no obvious renal injury. Continued hemorrhage resulted in laparotomy, which showed an 11 cm left adrenal tumor with massive hemorrhage into the retroperitoneum. Histologically the tumor was a benign non-functioning adrenal cortical adenoma.
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PMID:Massive retroperitoneal hemorrhage from an asymptomatic adrenal cortical adenoma. Report of a case. 271 7

Suprofen, a nonsteroidal anti-inflammatory drug, has been associated with the onset of acute flank pain, hematuria, and transient renal dysfunction after the ingestion of one or two doses, particularly in young males. Potential mechanisms of this nephropathy were evaluated in normal males following ingestion of suprofen (200 mg) on two occasions: the first with ad libitum fluid intake and the second during forced water diuresis. On the first study occasion, creatinine clearance, the fractional excretions of uric acid (FEUA) and sodium (FENa), the urinary concentration of undissociated uric acid, and the urinary excretions of prostaglandins and glomerular and tubular proteins were assessed. On the second occasion, inulin and PAH clearances and FEUA and FENa were determined. Within 90 min after suprofen administration, the FEUA increased from 8.8 +/- 2.6 to 35.5 +/- 9.6% (p less than 0.05). Urine became supersaturated for uric acid during ad libitum fluid intake. Glomerular filtration rate, renal plasma flow, and FENa decreased significantly, while prostaglandin and protein excretions did not change. The findings are consistent with acute uric acid nephropathy as a mechanism of suprofen-induced renal dysfunction.
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PMID:Suprofen-induced uricosuria. A potential mechanism for acute nephropathy and flank pain. 339 26

The value of ultrasound and 131-Hippuran renography for diagnosing hydronephrosis during pregnancy was investigated. In a control series of 31 symptom-free pregnant women the ultrasonographically measured renal pelvic diameters in the three trimesters were 5, 10 and 12 mm on the right side and 3, 4 and 5 on the left, respectively. In ten healthy non-pregnant women the pelvic diameter varied from 3 to 9 mm on the right side and from 2 to 6 mm on the left side when measured during antidiuresis and water diuresis. Out of 35 pregnant women complaining of flank pain, 31 showed an increased renal pelvic diameter. These 35 women also underwent renography on the same day as the ultrasound examination. In 6 of 27 pregnant women with right-sided pain and in 3 of 8 with left-sided pain, diuresis renography indicated acute ureteral obstruction and in 6 of these 9 patients impairment of renal parenchymal function was also evident. In some cases the impaired renal function was fully reversed after surgical intervention. It is concluded that ultrasound investigation of the kidney is a valuable method for screening prior to renography. Since the negative prediction value of using 17 mm as the upper limit of the pelvic diameter was 100%, patients with a smaller pelvic diameter may not need to be referred further for renography or urography, and radiation will thus be minimized. On the other hand, renography is indicated when the pelvic diameter is more than 17 mm in patients complaining of flank pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of hydronephrosis in pregnancy using ultrasound and renography. 391 76

We treated 13 patients with unilateral ureteropelvic junction obstruction by percutaneous endopyelotomy, and they were urodynamically evaluated by the Whitaker test and diuresis renography, in addition to excretory urography (IVP). Surgery was uncomplicated in all patients except 1 who required repeat incision 4 weeks later. Obstruction was diagnosed preoperatively by the Whitaker test and diuresis renography in 10 cases, and by IVP in 13. Postoperatively, all 10 patients (100%) with a positive Whitaker test were free of obstruction with a significant reduction in the relative renal pelvic pressure from 35.0 to 8.1 cm. water (p < 0.01). Diuresis renography revealed no obstruction in 8 patients (80%) and persistent obstruction in 2. IVP demonstrated reduced hydronephrosis in 8 of 13 patients (62%) 12 weeks after surgery and in 11 of 13 patients (85%) 19 months later. However, a marked reduction in renal pelvic size was noted in only 3 patients (23%). Flank pain disappeared in 10 of 11 patients (91%) postoperatively. Overall, surgery was successful in 11 of the 13 patients (85%). Percutaneous endopyelotomy was effective in relieving obstruction at the ureteropelvic junction with minor morbidity. The Whitaker test was more sensitive for evaluating the results of surgery than diuresis renography and IVP, although diuresis renography appears to be useful in followup evaluation of hydronephrosis.
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PMID:Urodynamic evaluation of results of endopyelotomy for ureteropelvic junction obstruction. 841 20

A followup study on nonhospitalized spinal cord injury patients using clean intermittent catheterization was conducted to evaluate long-term clean intermittent catheterization for any genitourinary complications, and to institute and evaluate prompt management. A total of 50 patients (36 paraplegics and 14 quadriplegics) was followed for 3 months to 6.5 years (average followup 22 months). All patients had a baseline urodynamic study and renal scan before they were discharged from the hospital. Patients with a reflex bladder and sustained, high intravesical pressures (greater than 40 cm. water) were placed on anticholinergic medication to lower voiding pressures and maintain continence. Those on clean intermittent catheterization and condom drainage were also given alpha-blockers to achieve low pressure voiding and to control autonomic dysreflexia. Of 50 patients 43 (86%) acquired a total of 364 events of significant bacteriuria (10(4) or more colony-forming units per ml.) at a rate of 13.63 infections per 1,000 patient-days on clean intermittent catheterization. Subclinical symptoms for urinary tract infection were noted in 22 of the 43 patients (51%), whereas clinical symptoms for urinary tract infection were recorded in 16 of 43 (37%). These symptoms included fever in 8 patients, chills in 3, hematuria in 3 and flank pain in 2. There were 31 genitourinary complications in 21 patients noted during periodic diagnostic evaluations, with 6 classified as upper tract. Of 50 patients 4 (8%) required rehospitalization for urological problems. One patient died of questionable sepsis. Transurethral sphincterotomy was performed in 15 of the 50 patients (30%) and transurethral prostatectomy was done in 1 for multiple reasons, for example high intravesical voiding pressures, difficult catheterization, repeated symptomatic urinary tract infections or per patient request to discontinue clean intermittent catheterization. Of 7 patients who were catheterized by others 4 elected to discontinue long-term clean intermittent catheterization after an average of 13 months. Overall, 33 patients (66%) discontinued clean intermittent catheterization and 17 are still being followed on a long-term basis. Clean intermittent catheterization is a successful long-term option to drain bladders in spinal cord injury patients who can perform catheterization independently.
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PMID:Clean intermittent catheterization in spinal cord injury patients: a followup study. 848 12

Nutcracker syndrome is caused by compression of the left renal vein between the aorta and the superior mesenteric artery, where it courses in the fork formed at the bifurcation of these arteries. The phenomenon results in left renal venous hypertension, which leads to left renal vein and left gonadal vein varices and unilateral hematuria. The main presenting symptom is hematuria, with or without left flank pain. The disorder is easily missed by routine diagnostic methods. Its incidence is likely underestimated. We report on a 25-year-old woman who experienced intermittent gross hematuria and left flank pain. The diagnosis of nutcracker syndrome was missed initially. Abdominal computed tomography, angiography, venography, and magnetic resonance angiography, which were later performed, showed that the left renal vein was compressed between the aorta and the superior mesenteric artery. The pressure gradient between the left renal vein and the inferior vena cava was 6.8 cm H2O. A diagnosis of nutcracker syndrome was established. She refused surgery and was lost to follow-up. The diagnosis and treatment of nutcracker syndrome are discussed. Magnetic resonance angiography is a safe and reliable tool for diagnosing this disorder.
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PMID:Nutcracker syndrome: an overlooked cause of hematuria. 1251 83