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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between April 1981 and July 1984, 51 patients received intraoperative radiation therapy (IORT) as a component of therapy for the management of primary or recurrent pelvic malignancies which were initially unresectable for cure. For these patients, curative surgical alternatives did not exist, or would have involved extensive procedures such as pelvic exenteration, distal sacrectomy, hemipelvectomy, or hemicorporectomy. The primary disease was colorectal in 38 patients. Treatment consisted of external beam radiation (range 3000 to 6890 cGy, median 5040 cGy), surgical debulking when feasible, and an intraoperative electron beam boost to the gross or microscopic residual disease (dose range 1000 to 2500 cGy, median 1750 cGy) utilizing 9-18 MeV electrons. The most common IORT associated toxicities were peripheral neuropathy and ureteral obstruction. None were life-threatening or fatal in severity. Of the 50 patients evaluable for neurotoxicity analysis, 16 (32%) developed peripheral neuropathy consisting of pain in 16 patients, numbness and tingling in 11, and weakness in 8. The pain, numbness and tingling resolved in about 40% of patients, while weakness resolved in only 1 of 8. Sixteen ureters were initially unobstructed by tumor at the time of IORT. Of these, 10 (63%) subsequently showed evidence of obstruction and hydronephrosis. The development of neurotoxicity was more common at IORT doses of 1500 cGy or more versus 1000 cGy. Ureteral obstruction with hydronephrosis occurred more frequently at IORT doses of 1250 cGy or more compared to 1000 cGy. There was no relationship between the likelihood of developing complications and the total external beam dose. The observed dependence of human nerve toxicity primarily on the IORT dose is consistent with data generated from animal experiments.
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PMID:Peripheral nerve and ureteral tolerance to intraoperative radiation therapy: clinical and dose-response analysis. 217 Oct 42

In a series of 517 operations for abdominal aortic aneurysm from 1971 to 1988 there were 45 cases (8.7%) with an inflammatory aneurysm with a typical thick glistening whitish fibrous layer. Almost two-third of the patients had rather severe chronic or acute progressive pain in the abdomen, the back or the flank. Unilateral (7) or bilateral (2) hydronephrosis due to ureteral compression occurred in 9 patients (20%). A diagnosis of inflammatory aneurysm was made preoperatively only in 10 patients. In 8 of the 9 patients with hydronephrosis ureterolysis was done, unilaterally (6) or bilaterally (2). After ureterolysis all had complete resolution of the hydronephrosis. Preoperative diagnostic methods are excretory urography, showing medial deviation, ultrasonography and CT-scanning of the abdominal aorta. All patients with an inflammatory aneurysm should undergo aortic replacement to prevent rupture and achieve pain relief. Ureterolysis in cases of hydronephrosis is strongly recommended and may be performed safely and with excellent results.
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PMID:Inflammatory abdominal aortic aneurysms. 222 60

A 30-year-old white woman with urinary frequency, left costovertebral angle pain and hematuria had left hydronephrosis, a marked decrease in bladder capacity and severe eosinophilic cystitis on biopsy. She was treated with a nonsteroidal anti-inflammatory drug and an antihistamine, with a dramatic, complete and rapid recovery. The nonsteroidal anti-inflammatory drug was believed to have been responsible for the favorable outcome, since antihistamines have not produced reliable benefits in this disease. Nonsteroidal anti-inflammatory drugs are recommended in cases of eosinophilic cystitis.
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PMID:Nonsteroidal anti-inflammatory drugs in the treatment of eosinophilic cystitis. 223 45

One hundred and seven patients with caliceal stones causing flank pain were treated by extracorporeal shock wave lithotripsy (ESWL), followed up and reviewed. The total stone-free rate 3 months after ESWL was 38.8%. The total pain-free rate was 50.5%. The pain-free rate was 85% in the stone-free group and 29% in the group with residual stones. No significant differences between the stone-free rate and the duration of pain or age was noted. Patients with abnormal intravenous pyelography (IVP) had a lower stone-free rate than patients with normal IVP (16 vs. 45%, p less than 0.05). The complications included: 6 cases of stone street formation with spontaneous passage; 1 case of stone street formation needing percutaneous nephrolithotomy for drainage; 1 perirenal hematoma; 9 cases of severe colic pain following ESWL; 3 cases of fever following ESWL, and 4 cases of hydronephrosis due to a stone in the ureterovesicle junction. These results show that ESWL is an effective, noninvasive treatment for painful caliceal stones.
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PMID:Management of painful caliceal stones by extracorporeal shock wave lithotripsy. 226 35

During the past three and half years (Jan, 1984-Jun. 1987), 14 cases of ureteropelvic junction obstruction presented with abdominal pain were encountered in the Department of Pediatrics, Mackay Memorial Hospital. Eight cases were male and six female. Their ages ranged from 4 years old to 12 years old. The duration of abdominal pain lasted for several days in 5 cases, several months in 4, and several years in another 5 cases. The abdominal pain was usually recurrent. It occurred once every 2 to 6 months. The location of pain was predominantly in the left abdomen and the periumbilical area. Cramping was the most characteristic symptom. Besides abdominal pain, several cases also had vomiting or abdominal mass. Laboratory examination showed some cases to have microscopic hematuria and others pyuria. All were proved by renal ultrasonography to have varying degrees of hydronephrosis. Intravenous pyelography or retrograde pyelography also confirmed the diagnosis of ureteropelvic junction obstruction. In 9 of the 14 cases, surgical intervention was performed to correct abnormalities. Six cases were followed up regularly; all showed improvement, however, one developed ureteropelvic junction obstruction on the contralateral kidney one year later. The remaining five cases who did not receive surgical treatment continued to have recurrent abdominal pain.
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PMID:[Ureteropelvic junction obstruction presenting with abdominal pain: a analysis of fourteen cases]. 227 77

After initial scepticism about its reality and despite a few disagreements, many authors now recognize the ovarian vein syndrome as a separate clinical entity, secondary to ureteral obstruction caused by dilation of the ovarian veins, which may cause lumbar pain, recurring pyelonephritis and/or lithiasic complications. The right side most frequently is affected because anatomical configuration of the right ureter is more susceptible to compression, and in fact, pregnancy appears to be an essential initiating or exacerbating factor. Thus, this anomaly might explain why painful and infectious manifestations and hydronephrosis so often develop on the right side (in over 95 p. cent of cases) during pregnancy. Its diagnosis thus must be known to be able to envisage its possible onset, by taking a careful history, and may be confirmed by certain radiological examinations. The latter, as well as treatment, depend on whether or not the patient is pregnant, its term, as well as severity of symptoms. Hence, erroneous diagnoses and incorrectly oriented surgical procedures may be avoided, while appropriate therapy is effective.
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PMID:[Ovarian vein syndrome]. 264 44

We report two successfully treated cases of ureteral endometriosis. Case 1 is in a 47-year-old female who had a past history of simple hysterectomy and right oophorectomy. Pathological diagnosis was myoma uteri and pelvic endometriosis. Two months later, she visited our clinic for right flank pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. The diagnosis of ureteral endometriosis was made from the past history and clinical features. Danazol therapy started with a daily dose of 400 mg. Sixteen days later, excretory urogram demonstrated complete resolution of the right hydronephrosis. An intravenous pyelography about 1 year after the danazol therapy has indicated no recurrence. Case 2 is in a 35-year-old female who visited our clinic for right lumbar pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. Right ureterocystoneostomy was performed unsuccessfully resulting in endoscopic dilation. Right lower ureter was buried in the dense fibrous tissue approximately 5 cm below the crossing with iliac vessels. The area of obstruction was removed. Histologically, endometriosis was diagnosed. Twenty nine cases of ureteral endometriosis including our two cases were collected from the Japanese literatures and reviewed with respect to the clinical features and treatment.
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PMID:[Two cases of ureteral endometriosis]. 266 Apr 99

Case 1: An 8-year-old boy consulted our clinic complaining of left flank colicky pain. He had a past history of the same episode. Ultrasonographic study was promptly performed. Left hydronephrosis was detected. At operation, left aberrant renal vessel was resected, and he has been free of pain. Case 2: A 65-year-old woman consulted our clinic because of abdominal pain and fever, who occasionally had the same episode. The existence and disappearance of the right hydronephrosis could be observed by emergency ultrasonography and following ultrasonic study, and the stenosis of the right lower ureter caused of cystitis cystica and glandularis was pointed out by retrograde ureterography. Diuresis ultrasonography by furosemide was performed to evaluate urinary tract stricture. In case 1, an incomplete obstruction pattern was obtained after operation, and in case 2, a complete obstruction pattern was shown. The emergency ultrasonography and diuresis ultrasonography were useful for the diagnosis and observation of intermittent hydronephrosis.
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PMID:[2 cases of intermittent hydronephrosis--usefulness of ultrasonography]. 266 May 22

A case of nontraumatic subcapsular renal hematoma was reported. The patient was a 41-year-old woman. She complained of right flank colic pain. Her excretory pyelography showed right hydronephrosis and ureteral stone, and demonstrated a large mass involving the right kidney and medial displacement of its collecting system. Ultrasonic examination and computed tomography revealed right subcapsular renal hematoma. Since we found no malignancy, we made a puncture and drained the lesion. A bloody aliquot was gained and its cytological examination was negative. Her clinical course was uneventful. After 6 months the hematoma was absorbed clearly. A review was made of 38 cases of nontraumatic subcapsular renal hematoma, including our own case. Of these, the cause was unidentified in 17 cases. Hydronephrosis, mostly associated with calculi, renal infarcts, nephritis and renal cell carcinoma followed. Of 38 cases, 2 (5.3%) were of malignant tumor.
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PMID:[Nontraumatic subcapsular renal hematoma: report of a case]. 266 May 23

A patient with acute myeloid leukemia (M4) in the first complete remission received a bone marrow transplantation (BMT) from an HLA-compatible sibling. Sustained engraftment was achieved, but she developed colicky pain at the back and lower quadrant of both sides on days 19-21 post-BMT, followed by hemorrhagic cystitis 13 days later. Ultrasonogram, intravenous pyelogram and computed tomogram of the abdomen showed hydronephrosis and ureteric obstruction of both sides. There was no stone in the urinary tract or abnormality of the bladder. The cortex of the right kidney was rather hypertrophic in spite of the persistent presence of hydronephrosis. Viral culture of urine and electron microscopic examination of urine sediments revealed the presence of adenovirus type II. Infection of the urinary tract with adenovirus type II may have been the underlying cause of the hemorrhagic cystitis and possibly also of the otherwise unexplained ureteric obstruction.
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PMID:Ureteric obstruction after allogeneic bone marrow transplantation: an unusual complication. 267 67


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