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

Aortic dissection is a life-threatening illness requiring early diagnosis and treatment. Uncommon early presentations mimicking various illnesses can delay diagnosis. This case study describes a 44-year-old woman with type B aortic dissection initially presenting as acute pyelonephritis (APN). Early clinical manifestations were sudden onset of left flank pain, fever, hematuria and pyuria, and following admission, severe abdominal pain, nausea, vomiting, reduced urine output and renal function deterioration. Abdominal computed tomography showed type B aortic dissection complicated with a small bowel infarct, ischemic ascending colon and left renal infarct. Emergency surgical interventions of small bowel resection, ileoduodenostomy and cholecystectomy were performed; a second laparotomy was subsequently performed for anastomosis leakage. The patient died due to septic shock with multiorgan failure. Aortic dissection initially mimicking APN is rare. Accurate early diagnosis of aortic dissection with indeterminate presentation is crucial. Early surgical intervention for visceral organ ischemia is important to preventing morbidity and mortality.
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PMID:Type B aortic dissection with early presentation mimicking acute pyelonephritis. 1687 95

A patient, born in 1961, is hospitalised for pubic abdominal pain with irradiation to the right and left sides. She has a Turner's syndrome. At first evaluation, an abdominal tomography demonstrates a right pyelonephritis. The patient is treated with quinolones and she evolves favourably, except that she continues to present some abdominal pain. She leaves the hospital, but because of permanent abdominal pain, a new abdominal tomography is performed: an aortic dissection type B for (Stanford), or III anterograde for (De Bakey), is diagnosed. Cardiovascular anomalies are frequent in Turner's syndrome. Aortic dissection is a rare complication. Histological analysis shows a cystic medial necrosis. Medical and cardiological follow-up is needed.
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PMID:[Clinical case of the month. Turner's syndrome and aortic dissection]. 1702 Feb 28