Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a 23-year-old woman with lumbar pain, an expansive process in the right kidney was demonstrated by I.V.P., retrograde pyelography and renal angiography. The histological examination subsequent to nephrectomy showed endometriosis in association with localized xanthogranulomatous pyelonephritis. Renal endometriosis has been described only eight times previously in the literature. The current case is discussed and compared with previous reports.
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PMID:Renal endometriosis. A case report. 89 82

The urinary tract is rarely affected by endometriosis, urinary bladder being the most common location. This paper presents one case of advanced extrinsic endometriosis which initially presented as obstructive pyelonephritis. The diagnostic methodology, including uro-tomographic imaging, is evaluated. Although good results have been reported with hormone-therapy, we support the surgical approach sanctioned by the patho-anatomical findings.
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PMID:[Ureteral obstruction secondary to endometriosis. Report of a case]. 834 31

Besides early diagnosis, the prognosis of gynecological disease is dependent on the state of the urinary tract. Mainly tumours and site anomalies of the female genital system as well as endometriosis and chronic-inflammatory masses of the appendages lead to malfunction of urinary bladder, ureter and kidneys. Ureteric changes are seen in 3 to 55% of genital tumours and in 20 to 40% of cases of endometriosis. Ureteric and kidney dysfunction can occur even more often in longstanding site anomalies. Typical renal complications of gynecological diseases are pyelonephritis, pyelectasy and hydronephrosis. Their frequency lies between 8 and 40% depending on kind and duration of the underlying disease. The figures shown, indicate that renal and ureteric changes sometimes are more serious than the genital disease. Improvement of prognosis can only be achieved by early recognition of the underlying gynecological disease together with the timely proof of renal and ureteric dysfunction.
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PMID:[Prognosis in gynecologic diseases]. 885 76

Ureteral endometriosis is a rare disease that typically is unilateral. Endometriosis involving both ureters and surgical management after hormone therapy failure has seldom been described. We describe a patient with bilateral ureteral endometriosis who underwent ureteroneocystostomy with psoas hitches of both ureters. A 33-year-old woman with advanced endometriosis and recurrent pyelonephritis was found to have high-grade bilateral ureteral obstruction at the pelvic inlet from ureteral endometriosis. The patient subsequently underwent a supracervical hysterectomy with bilateral salpingo-oophorectomy, ureterolysis, and ureteroneocystostomy with psoas hitches and ureteral stent placements. Surgical therapy is reserved for advanced disease with the optimal choice being a ureteral reimplantation with a psoas hitch. The key operative point for a successful psoas hitch ureteral reimplantation is completely mobilizing the bladder anteriorly and laterally.
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PMID:Surgical management of bilateral ureteral endometriosis. 1711 90

A late consequence of ureteral endometriosis is the silent loss of renal function caused by progressive "enclosure" of the lower part of the ureter by the endometriosis. In our experience, in cases of severe loss of renal function with cortical atrophy and residual kidney function (evaluated by Tc99 DMSA scintigraphy) of less than 15%, removal of the endometriosis combined with ureterolysis does not allow recovery of renal function. A nonfunctioning kidney associated with hydronephrosis is a risk factor for vascular hypertension, recurrent pyelonephritis, or kidney stones and therefore an indication for nephrectomy. By means of a case report, this paper describes the combination of laparoscopic nephrectomy, ureterectomy, removal of the rectovaginal endometriotic nodule, and extraction of the kidney through the vagina.
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PMID:Combined laparoscopic and vaginal approach for nephrectomy, ureterectomy, and removal of a large rectovaginal endometriotic nodule causing loss of renal function. 1736 68

Ureteral endometriosis is a rare yet important entity that can lead to renal failure due to silent obstruction of the ureter. Awareness of clinical and morphologic features can help in early detection and treatment. We analyzed the clinical, pathologic, and immunohistochemical findings of 7 cases of ureteral endometriosis. Mean age of patients was 51 years. All patients presented with hydroureter, accompanied in the most cases by hydronephrosis. Superimposed pyelonephritis was experienced by 2 of 7 patients. Most patients (4 of 7) had previously undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy. In 6 of 7 cases, endometriosis involved the left ureter. The distal one third of the ureter was involved in 6 cases, whereas the middle third was involved in 1 case. In 4 cases, endometriosis was located extrinsic to the ureter, whereas in 3 cases, the ureter showed intrinsic involvement by endometriosis. One case showed simple endometrial hyperplasia. Surgical management included nephrectomy in 2 cases, distal ureterectomy with reimplantation in 3 cases, ureteral stent placement followed by ureteroureterostomy in 1 case, and relief of ureteral obstruction by resection of pelvic endometrioma in 1 case. Immunostains for cytokeratin-7 (CK7) and progesterone receptor (PR) were positive in all of the cases, whereas immunostains for estrogen receptor (ER) were positive in 83% of cases and immunostains for CK20 were negative in all cases. CA125 immunostains were positive in 67% of cases. The stromal cells were positive for CD10, ER, and PR immunostaining. Our findings suggest that the diagnosis of ureteral endometriosis is preceded in most cases by hysterectomy and bilateral salpingo-oophorectomy, possibly because of prior symptoms related to adenomyosis or pelvic endometriosis and that ureteral endometriosis has a strong predilection for involvement of the lower third of the left ureter. Ureteral endometriosis should be included in the differential diagnosis of obstructive ureteral lesions in women, particularly those involving the lower third of the left ureter, even in postmenopausal patients. Immunostains for ER, PR, CK7, CA125, and CD10 can be helpful in challenging cases.
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PMID:Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases. 1853 72

The transitional cell carcinoma (TCC) of the upper urinary tract is relatively uncommon. The clinical presentation of TCCs and many other diseases of the upper urinary tract are nonspecific, and most of these lesions are usually necessary to be evaluated by computed tomography (CT) urography. CT appearances of TCCs can be classified as papillary, infiltrating papillary, and diffusely infiltrating tumor. Most TCCs of the upper urinary tract can be identified on the bases of characteristic CT appearances. However, some benign lesions may mimic different categories of TCCs and should be taken into account for differentiating diagnosis. These lesions include endometriosis, nephrogenic adenoma, mycetomas, malacoplakia, and inflammatory pseudotumor which are similar to infiltrating papillary TCCs; complex urolithiasis, passed stone of ureter and ureteropelvic junction, chronic ureteropelvic junction obstruction with superimposed infection, atypical pyelonephritis, and tuberculosis which mimic diffusely infiltrating TCCs, and fibroepithelial polyp which has the same CT appearances as papillary TCCs. The useful CT signs to make differential diagnosis involve enhanced pattern, location of lesion, induration of urinary tract, and range of thickening of urinary wall. The three-dimension (3D) reconstructed images is useful in making differential diagnosis.
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PMID:Transitional cell carcinoma of upper urinary tract vs. benign lesions: distinctive MSCT features. 1858 Nov 62

Endometriosis is the ectopic growth of viable endometrium outside the uterus, affecting approximately 7% of females. It commonly affects pelvic structures including the bowel. Perforation of the colon by endometriosis is very rare and the patients generally present with an asymptomatic or painful pelvic mass, often in the left iliac fossa. Our patient presented acutely unwell and her symptoms were more suggestive of pyelonephritis or diverticulitis. We therefore report an unusual cause of acute abdomen. The purpose of the following case report is to elucidate certain diagnostic and therapeutic problems of the disease, concerning both surgeons and gynaecologists. In summary, intestinal endometriosis should be considered in the differential diagnosis of all post-menarche women with episodic gastrointestinal symptoms. A past history of endometriosis or co-existent gynaecological symptoms should increase the index of suspicion, and laparoscopy prior to formal laparotomy should be considered. Our patient, in retrospect, had a history of mild endometriosis, but we feel that this case serves as a reminder of a rare, but important, differential diagnosis of acute abdomen in females.
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PMID:Intestinal endometriosis--a rare cause of colonic perforation. 1919 65

This case report describes a woman with spontaneous rectal perforation from decidualized endometriosis in pregnancy. A 37-year-old woman was admitted to our hospital at 30 wk of pregnancy with symptoms suggestive of pyelonephritis, which persisted until 33 wk of gestation when delivery of a premature male baby was performed through a cesarean section. On postoperative day 2, an abdominal computed tomography showed free air in the peritoneal cavity and a pelvic abscess. Explorative celiotomy revealed a diffuse severe fecaloid peritonitis that originated from a 3-cm wide rectal perforation. A Hartmann operation was then performed. Histopathological findings were consistent with decidualization of the rectal wall. Only 20 cases of intestinal perforation due to endometriosis have been reported in the literature. This report is believed to be the first case of spontaneous rectal perforation from endometriosis in pregnancy, and it shows the potential occurrence of serious and unexpected complications of the disease.
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PMID:Rectal perforation from endometriosis in pregnancy: case report and literature review. 2012 37

Spontaneous endometriosis is an estrogen-dependent, progressive and painful disease that affects a variety of nonhuman primates, including several species of baboons (Papio sp.). This case documents multimodal management of severe endometriosis in a captive female baboon within a zoological institution. An 18-yr-old, intact female Guinea baboon (Papio papio) was found to have an enlarged uterus. Fifteen months post ovariohysterctomy, scarring associated with endometrial tissue resulted in ureteral strictures, bilateral hydronephrosis, and azotemia. Cystoscopic placement of bilateral ureteral stents with fluoroscopy was performed and resulted in short-term clinical improvement. The animal's condition declined and euthanasia was elected 4 mo after ureteral stent placement. Severe endometriosis with secondary inflammation resulting in bilateral hydroureter and hydronephrosis, as well as concurrent cystitis, ureteritis, and pyelonephritis were confirmed at necropsy. Despite possible complications, ureteral stents can be considered a useful therapeutic option in patients with ureteral disease.
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PMID:Bilateral hydronephrosis secondary to endometriosis managed by endoscopic ureteral stent placement in a captive Guinea baboon (Papio papio). 2220 76


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