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)

Periodic structures with equally spaced radial striations, identified as Liesegang-like rings, were encountered in fine needle aspirates of two patients' hemorrhagic renal/perirenal cysts. The patients, one 60 and the other 39 years old, had acute right-flank pain; both underwent nephrectomy. The ring structures ranged in size from 8 microns to 200 microns in diameter and had regularly striated double walls. Histochemical and immunoperoxidase tests for iron, calcium, mucopolysaccharides, amyloid, keratin and hemoglobin performed on the tissue sections of the resected specimens gave negative results. With electron microscopy, the ring structures of one of the cases displayed a fine fibrillary composition. Since these Liesegang-like structures may be mistaken for parasites or necrotic tissue, pathologists should be aware of them. To our knowledge, this is the first report of Liesegang-like rings in the cytology literature.
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PMID:Liesegang-like rings in fine needle aspirates of renal/perirenal hemorrhagic cysts. 304 22

Periodic structures with equally spaced radial striations identified as Liesegang-like rings were seen in two male patients' hemorrhagic perirenal cysts. The patients, one 48 and the other 60 years old, had acute right-flank pain and anemia; both had nephrectomy. The rings, initially believed to represent parasites (Dioctophyma renale), were from 8 to 500 micron in diameter and had uniform, pink-tan, radially striated double walls. Multiple small rings within a larger ring predominated in one case. Morphologically, the rings differed from D. renale when compared with specimens from animals infected naturally or experimentally with the giant kidney worm. Histochemical and immunoperoxidase tests for iron, calcium, mucopolysaccharides, amyloid, keratin, and hemoglobin had negative results. Energy-dispersive x-ray elemental analysis demonstrated no detectable elements; ultrastructurally, however, the rings displayed a fine fibrillary composition with a concentric and radial pattern. These rings are believed to be an end product of a phenomenon resembling or are, in fact, the Liesegang phenomenon. Because these Liesegang-like structures may be mistaken for parasites on fine-needle aspiration or surgical specimens of hemorrhagic areas, pathologists should be aware of them.
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PMID:Pseudoparasitic Liesegang structures in perirenal hemorrhagic cysts. 334 Dec 76

Anecdotal reports of chronic contained rupture of abdominal aortic aneurysms exist. Their existence and implications have been largely ignored. From March 1984 to March 1985, 24 patients required repair of an infrarenal abdominal aortic aneurysm. Four patients underwent emergent repair. The remaining 20 patients were evaluated with computed tomography electively. Seven patients (35%) were demonstrated to have a rupture of the aneurysm and a retroperitoneal hematoma on the computed tomographic scan. All of the patients had histories of back or flank pain; five patients continued to complain of mild pain on admission. In no case was shock, impending shock, or a decrease in the hemoglobin level present on admission. All patients were operated on within 24 hours of evaluation. At operation, rupture was noted with organized hematoma outside the aorta contained in a pseudoaneurysmal wall of retroperitoneal connective tissue. There was no intraperitoneal blood. There was no operative mortality and survival was 100% at six months. The CT scan evaluation had identified a subgroup of patients with aneurysms associated with chronic contained rupture.
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PMID:Chronic contained rupture of abdominal aortic aneurysms. 370 32

A report on a patient who sustained a burn and perforation of the urinary bladder from visible sparks emanating from a unipolar coagulating device during the couse of laparoscopic sterilization is presented. It is the first report of urinary bladder burns using a unipolar coagulating device. A 24-year-old woman, gravida 10, para 3, abortus 7, underwent a laparoscopic sterilization with a unipolar coagulating device. As the physician was finishing the coagulation, a spark from the device caused a 1-2 cm burn with a central area of perforation into the urinary bladder. Conservative treatment was recommended, and consisted of Foley catheterization and drainage for 5 days. Initial urine culture revealed Klebsiella species, and oral ampicillin was prescribed. Hematuria was noted throughout the patient's hospitalization, and blood clots were present in the urine on Day 2 postoperation. The patient had no abdominal or flank pain, was afebrile, and had a stable hemoglobin level during the hospital stay. Cystography was performed on Day 5 postoperatively and demonstrated no perforation. Foley catheter was removed. Patient was discharged 2 days later and remains in good health 3 months postoperatively.
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PMID:Bladder perforation owing to a unipolar coagulating device. 728 1

A case in which pathologic enlargement of the left kidney was simulated by splenic compression in a 17-year-old boy with hemoglobin SC disease and recurrent left flank pain is presented. The true nature of the apparent enlargement was demonstrated by computed tomography.
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PMID:Splenic compression of the left kidney simulating pathologic unilateral renal enlargement. 736 22

A case of subcapsular hematoma, a rare complication of acute pyelonephritis (APN) is described. A 60-year-old diabetic woman was admitted with a 3 day history of fever and left flank pain due to acute pyelonephritis. On the third day in hospital, left flank pain worsened despite use of antibiotics available for the treatments of APN and hemoglobin rapidly decreased from 11.1 to 7.9 g/dL. Ultrasonography and abdominal CT showed left subcapsular hematoma. Renal angiography demonstrated an ovoid avascular zone between the capsular artery and parenchyme of the left kidney with no evidence of tumors or vascular abnormalities, such as arteriovenous malformation or fistula. Subsequent percutaneous drainage of this subcapsular hematoma was performed and showed old blood-colored drainage. Hereby, the possibility of subcapsular renal hematoma in the course of acute pyelonephritis is stressed as a rare complication.
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PMID:Subcapsular hematoma as a complication of acute pyelonephritis: a case report. 981 Nov 89

An 83-year-old woman was transferred to our cardiac intensive care unit with an acute non-Q-wave myocardial infarction and pulmonary edema. Enoxaparin was one component of the treatment regimen used. Her hospital course was complicated by episodes of hypotension, as well as by recurrent left hip and left thigh pain. The defining event occurred when the patient became acutely hypotensive and developed abdominal distention, peritoneal signs, intense left flank pain, and a 3.3 g/dl hemoglobin decrease. Abdominal computed tomography showed a 9 x 6 x 20 cm left retroperitoneal hematoma. The hematoma was spontaneous, secondary to enoxaparin use. The patient died despite vigorous supportive care. Enoxaparin is being increasingly used in patients with acute coronary syndromes. Review of the medical literature revealed that this is the first reported case of a patient with an acute coronary syndrome who died as a result of an enoxaparin-induced, spontaneous retroperitoneal hematoma. This article reviews important clinical signs and symptoms, identifies high-risk patient populations, and discusses management strategies.
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PMID:Fatal spontaneous retroperitoneal hematoma secondary to enoxaparin. 1260 17

Spontaneous rupture of metastatic adrenal tumor with massive retroperitoneal hemorrhage and shock is an uncommon clinical event. Herein, we report a case of hepatocellular carcinoma (HCC), where left hepatic lobectomy and right adrenalectomy for metastatic HCC were performed in April and August 2002, respectively. Subsequently, the patient presented to the emergency room with acute-onset severe left flank and back pain in March 2004, accompanied by a falling hemoglobin level. Computed tomography revealed a 7-cm left adrenal tumor mass with retroperitoneal hemorrhage. The ruptured adrenal tumor was further confirmed by selective angiography, which demonstrated that the bleeder was supplied by the left suprarenal artery. Transarterial embolization (TAE) to stop tumor bleeding was performed successfully. The patient then underwent tumor resection with left adrenalectomy 5 days after the embolization, with pathology subsequently revealing metastatic HCC. The recurrent intrahepatic HCC was controlled with TAE, and the patient underwent hormone replacement therapy with prednisolone 10 mg/day. Metastatic adrenal tumor bleeding should be suspected in hepatoma patients who suffer abrupt flank pain and shock. Hemodynamically unstable patients require supportive transfusions and urgent surgical exploration. Angiographic embolization, if deemed feasible, may be a valuable adjunct for achievement of hemostasis prior to definite surgery.
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PMID:Treatment of massive retroperitoneal hemorrhage from adrenal metastasis of hepatoma. 1738 58

Renal medullary carcinoma (RMC) is an aggressive neoplasm occurring almost exclusively in adolescents and young adults with sickle cell (SC) hemoglobinopathies, usually sickle cell trait (SCT) or hemoglobin SC disease. The most common presentations are hematuria and flank or abdominal pain. It is a highly malignant tumor, and responses to chemotherapy are rare and transient resulting in a dismal prognosis. A high level of suspicion is necessary when evaluating at risk patients presenting with hematuria or flank pain, as currently it appears that only early diagnosis could potentially alter the outcome of this disease. We report a case of RMC in a young male patient with SCT, who presented to the emergency department with low back pain and microscopic hematuria, clinically mimicking acute obstructing urolithiasis. Our case emphasizes the need to consider alternate diagnoses when evaluating computed tomography scans for acute flank pain.
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PMID:Renal medullary carcinoma: unsuspected diagnosis at stone protocol CT. 1740 14

Spontaneous rupture of the kidney is uncommon; here we report a case of spontaneous rupture of the kidney due to a rhabdoid tumor. An 11-year-old boy presented with left flank pain and hematuria, was admitted to a hospital where he was found to have an abnormality of the left kidney on computed tomography (CT) scan. He was referred to our department for further evaluation and treatment on the next day. Spontaneous rupture of left renal tumor was suspected by a drop in hemoglobin level, hemoglobin decreased from 9.2 to 7.6 mg/dl within 72 h. The hemoglobin level continued to drop despite blood transfusion. Urgent trans-abdominal exploration of the left kidney was performed. During the operation, rupture of left renal tumor with massive bleeding was noted. Para-aortic lymph node metastasis is evident. The surgical specimen contained a large peri-renal hemorrhage and tumor rupture into peri-pelvic soft tissue. Histopathological diagnosis was rhabdoid tumor consisting of round nuclei, prominent nucleoli and eosinophic cytoplasm. Two courses of adjuvant chemotherapy with actinomycin D, vincristine and epirubicin and radiotherapy (1,200 cGY) were performed post-operatively. The patient died 5 months after operation due to metastasis of the tumor to the lung and intra-abdominal organs.
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PMID:Rhabdoid tumor of the kidney with spontaneous rupture: case report and review of literature. 1749 91


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