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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of nephron-sparing surgery for renal cell carcinoma is well established in patients with an anatomical or functional solitary kidney (imperative indication) in which a radical nephrectomy would render the patient anephric with subsequent need for hemodialysis. This also encompasses patients with a unilateral renal cell carcinoma and a functioning contralateral kidney when the opposite renal unit is affected by a disease that might threaten its future function, such as renal artery stenosis, chronic pyelonephritis, stone disease or systemic conditions such as diabetes. A functioning renal remant of at least 20% of normal renal parenchyma seems to be necessary to avoid end-stage renal failure in these patients [16]. There have been several reports in the literature of excellent 5-year cancer-specific survival rates of over 80% in such circumstances [12, 15]. These results were confirmed in our institution, with a 5-year cancer-specific survival rate of 83% in over 70 patients with an imperative indication for nephron-sparing surgery. Thereby the prognosis was significantly influenced by the local tumor stage and the grade of malignancy. These data support the efficacy of nephron-sparing surgery in this clinical situation.
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PMID:Current controversies in nephron-sparing surgery for renal-cell carcinoma. 755 Mar 88

Xantogranulomatous pyelonephritis is a severe chronic form of renal parenquimal infection that usually results in diffuse renal destruction. An unusual case of xanthogranulomatous pyelonephritis in a child is reported which presented as a focal mass without calculus in a functioning kidney and was diagnosed as a renal tumor.
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PMID:Focal xanthogranulomatous pyelonephritis simulating malignancy in children. 762 Apr 25

An 18-month-old female child presented with fever and an abdominal mass, which, after ultrasonography, computed tomography, and magnetic resonance imaging was considered to be an atypical cystic renal neoplasm. Nephrectomy was performed. Histopathological examination demonstrated the mass to be focal xanthogranulomatous pyelonephritis. This lesion should be considered in the differential diagnosis of renal neoplasms in childhood, particularly cystic Wilms' tumor or Wilms' tumor with significant intratumoral hemorrhage.
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PMID:Focal xanthogranulomatous pyelonephritis in a young child. 793 3

Although various complications such as electrolyte imbalance and urinary infections are known to be induced, ureterosigmoidostomy may still prove to be useful on selected patients who desire a continent form of internal diversion. At our hospital, we performed nineteen ureterosigmoidostomy operations in the seven years between 1981 and 1987. Herein, we have reviewed the postoperative conditions of electrolytes, renal function and other complications. The patients (17 male, 2 female) were between 43 and 75 years old, the mean being 60.3 years. The primary disease was bladder tumor with histopathological findings of transitional cell carcinoma (17) and squamous cell carcinoma (2). Post-operative fluctuations in electrolyte values of Serum Na and Serum K were within the normal value. Hyperchloremia was initially detected in four cases (21.0%), but these were only slightly above the normal range and a year after the operations the conditions were stabilized. Although blood urea nitrogen had a tendency to elevate one or two years after the operation serum creatinine fluctuated within the normal range. After the operations, we administered 10% sodium potassium citrate solution to all patients to prevent hyperchloremic acidosis. During the observation period, only four out of nineteen cases (21.0%) exhibited pyelonephritis. No other complications were observed. Postoperative excretory urograms revealed slight to medium hydronephrosis two months after the operation in four out of nineteen cases but most of these conditions were normalized within a year. Nine patients died after leaving the hospital; seven due to the recurrence of cancer and two due to pneumonia. The ten remaining patients are enjoying normal lives without the use of any external urinary device.
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PMID:[Clinical evaluation on long-term complications of ureterosigmoidostomy]. 807 55

Renal parenchymal malacoplakia is uncommon, and coexistence of extensive invasion into the liver and duodenum is extremely rare. Typically, there is an associated long-term urinary tract infection. We report on a 53-year-old woman with a history of diabetes and recurring pyelonephritis, who presented with a renal tumor and upper gastrointestinal bleeding. Surgical intervention included radical nephrectomy, lymphadenectomy, segmental hepatectomy, cholecystostomy, duodenorrhaphy, jejunostomy and appendectomy. There was no surgical morbidity. A pathologist confirmed the diagnosis of malacoplakia. All of the diagnostic criteria, including hematoxylin and eosin stain, iron stain, calcium stain and electron microscopy of Michaelis-Gutmann bodies, were classic. The literature is reviewed.
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PMID:Renal malacoplakia with secondary hepato-duodenal involvement. 812 44

A case of renal pseudotumor due to pyelonephritis is reported. A 70-year-old female was admitted to our hospital for the evaluation of right renal mass in pyelogram. She had had episodes of pyelonephritis many times. Computed tomography (CT) revealed poorly marginated low density mass that exhibits inhomogenous enhancement with contrast medium. Angiography showed an avascular mass. On magnetic resonance imaging (MRI), the mass was isointensity or slightly low intensity on T1 weighted scan, while it showed low intensity on T2 weighted scan. The patient died from small cell carcinoma in the lung two years later. Autopsy was performed and no malignancy was found in the kidney. MRI was useful to differentiate such inflammatory change from renal tumor, which is mostly high intensity on T2 weighted scan.
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PMID:[A case of renal pseudotumor caused by pyelonephritis]. 817 43

Herein, we report two cases of squamous cell carcinoma of the ureter. The first case was in a 56-year-old-male. Total cystectomy and ileal conduit were performed because of bladder tumor suspected to be accompanied by carcinoma in situ and atrophic urinary bladder induced by chronic cystitis in December, 1993. Pathological examination revealed transitional cell carcinoma (TCC) > squamous cell carcinoma (SCC), G2 > G1, INF beta, pT1, 1y1, v1. He complained of back pain under medical observation in December, 1994. Left hydronephrosis was found and antegrade pyelography showed leakage from the left pelvic ureteral junction. Urinary cytology revealed class V and suggested TCC. He received left nephroureterectomy, and pathohistological examination of resected specimen revealed SCC, INF gamma, pT3, pRo, pLx, pVx, pNo, pMo. CABO chemotherapy (cisplatin, methotrexate, bleomycin, vincristine) was performed postoperatively. The second case was in a 61-year-old female. She complained of macrohematuria in the course of observation of pyelonephritis. Drip infusion pyelography showed right hydronephrosis and retrograde ureterogram revealed stenosis of the right lower ureter. Urinary cytology revealed class V. Nephroureterectomy and bladder cuff were performed. The tumor was histologically diagnosed as SCC > TCC, INF beta, pT3, pRo, pLo, pVo, pNo, pMo. Postoperatively, CABO chemotherapy was performed. So far, no recurrence has been observed. Fifty five cases of squamous cell carcinoma of ureter were collected from the Japanese literatures including our cases.
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PMID:[Two cases of squamous cell carcinoma of the ureter]. 853 90

Authors used the Mainz pouch II technique for urinary diversion in 40 patients suffering from bladder cancer. They made minor modifications to the original surgical technique: a longer, 40 cm bowel is detubularized, the ureters are pulled through the mesosigma and embedded in a groove of the bowel's mucosa, the sigma pouch is fixed to the dorsal peritoneum, a straight suture is used. Single-row on the dorsal wall and two-rows on the ventral wall. Within a few days after the surgery suture insufficiency occurred in the abdominal wall in 5 cases, in the bowel in 2 cases. To treat suture disrupture of the bowel authors transformed the pouch, added a newly detubularized bowel segment to create a spheric rectum pouch and performed a definitive colostomy. During the follow-up period of six months to four years 8 of the 40 patients died from bladder cancer, 2 from cardiac failure, 1 from pulmonary embolism, and 6 have had a recurrence of the tumor. In the 23 tumor free patients we found no reflux, one has a slight stenosis of the ureter, febrile pyelonephritis did not occur, the pouch did not slip, the ureter had no kinking, and all patients are continent. Hyper-chloraemic acidosis has been prevented by regular administration of sodium bicarbonate or kalium citrate. Authors believe that Mainz pouch II is to be the most appropriate continent urinary diversion if an orthotopic substitution is not possible.
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PMID:Our experience with the Mainz pouch II: 40 patients; follow-up and complications. 855 96

Renal metastases from solid tumors to both kidneys rarely result in acute renal failure (ARF). We present a case of squamous cell pulmonary carcinoma responsible for ARF due to (1) extensive (50% to 75%) bilateral parenchymal infiltration and replacement accompanied by tissue destruction, (2) widespread vascular invasion and thrombosis resulting in ischemia, and (3) histological evidence for foci of distal intratubular obstruction and pyelonephritis. Five additional cases, including one pulmonary cancer, causing ARF from extensive tissue replacement and destruction are reviewed. In a separate case, ARF resulted from lymphatic metastases rather than from parenchymal destruction or obstruction. Common findings in all six reported cases include bilaterally enlarged kidneys and progressive oligoanuria despite correction of prerenal or postrenal conditions. In our patient and in one other prior reported case, extrarenal obstruction was not considered important because invasive therapeutic procedures were unsuccessful in reversing ARF. In one case, irradiation of kidney tumor resulted in reversal of ARF. These cases emphasize the rare potential for solid tumors to metastasize to both kidneys and result in irreversible oligoanuric ARF. A high level of suspicion is required, and an early diagnosis may result in reversible ARF if the tumor is amenable to chemotherapy or irradiation.
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PMID:Acute renal failure secondary to solid tumor renal metastases: case report and review of the literature. 865 8

Surgical aid in acute hemorrhage due to cancer of the urinary bladder was rendered within 1986-1994 to 65 patients (53 males and 12 females) aged 30-50, 51-60, 61-70 and over 70 years (10, 11, 24 and 20 cases, respectively). The majority had the disease stage T2 and T3. In 42 (64.6%) patients with profuse hematuria complicated by bladder tamponade an urgent resection was performed: segmental in 22, hemiresection in 8, open bladder electroexcision of the tumor in 10 patients. 2 patients had sigmoid cancer with bladder involvement managed by subtotal resection of the bladder and resection of the sigmoid colon. Nephro- or cystostomy was performed because of grave condition (purulent pyelonephritis, azotemia) in 23 patients (35.4%). Total postoperative lethal outcomes made up 33.3% (14 patients): 6 patients died early after surgery, 8 patients 6 months to 8 years later. 27 patients (64.3%) are alive. Of them 10 are 5-8-year survivors. These patients had cancer stage T2 and T3 with tumor location on the lateral wall. In three 4-year survivors there were tumor recurrences 2 and 3 years after surgery which were treated by transurethral resection and electroexcision on the open bladder. Long-term outcomes of urgent surgery show that different kinds of resection of the bladder may be effective in the treatment of acute hemorrhages from bladder tumors.
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PMID:[The late results of organ-preserving operations in acute hemorrhages in patients with bladder cancer]. 867 44


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