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)

We reviewed the course of 500 patients with Crohn's disease to document the incidence, the nature, and the results of management of fistulas to the bladder. Seventeen patients (14 men and three women) had developed enterovesical fistulas: 16 had pneumaturia. The barium radiographs demonstrated the fistula in only 37%. All had received sulfasalazine, and most were treated with corticosteroids and antibiotics intermittently; two had successful control of their urinary symptoms on this regimen. Eight patients who received 6-mercaptopurine (6-MP) in addition tolerated the urinary fistula well, so that we encourage a trial of 6-MP for this complication of Crohn's disease. Six patients continue on medical therapy alone after a mean of 5.3 years. There were no instances of pyelonephritis during 60 patient years. Eleven patients eventually underwent bowel resection, but in only two was persistence of the enterovesical fistula the primary indication for elective surgery, and in both, it was the patient's choice. Visualization of the fistula on barium enema radiograph or presence of a connection between the sigmoid and the bladder were not associated with adverse outcome. An enterovesical fistula in Crohn's disease rarely leads to serious complications and can often be treated successfully with medical therapy alone: by itself, it need not serve as an indication for surgery.
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PMID:Management of bladder fistulas in Crohn's disease. 256 89

Renal pelvocaliceal mucosal opacification has been observed clinically in patients with inflammatory disease. We studied the microvascular changes that might be responsible for this finding using barium injection and microradiographic studies of 20 human kidneys excised due to infection. There were six patients with staghorn calculi and chronic pyelonephritis, four with pyohydronephrosis, eight with acute and chronic pyelonephritis, and two with xanthogranulomatous pyelonephritis. The microangiograms correlated with severity of inflammation. In mild cases, slight vessel hypertrophy involved the terminal arterioles and arteries supplying the urothelium. In severe cases, there was marked neovascularity with feeding vessel hypertrophy and mucosal thickening. Our studies demonstrate that abnormal pelvocaliceal vascularity is responsible for the findings seen on urography and angiography of inflammatory disease.
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PMID:Urothelial microvascular response to chronic renal inflammatory disease. 318 99

Gas-forming infections of the genitourinary tract may manifest as life-threatening conditions, often requiring aggressive medical and surgical management. Accurate interpretation of the radiologic studies is essential for early and accurate diagnosis of gas within the renal parenchyma or collecting system, bladder, uterus, and scrotum. Three distinct entities are associated with renal or perirenal gas: emphysematous pyelonephritis, emphysematous pyelitis, and gas-forming perirenal abscess. Gas in the bladder may occur secondary to emphysematous cystitis or a vesicoenteric fistula and must be differentiated from air introduced by means of instrumentation. Uterine gas usually indicates an underlying infection or a neoplasm. Gas in the scrotum is most commonly due to an infectious process or bowel herniation into the scrotal sac. Before institution of a specific therapeutic regimen, an effort should be made to establish the exact location of gas in the genitourinary tract. Plain radiography, including tomography, and ultrasonography are useful screening modalities. Although in some cases urography, barium enema studies, and other contrast material-enhanced studies enable a diagnosis to be made, in many patients computed tomography is the definitive diagnostic technique.
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PMID:Genitourinary tract gas: imaging evaluation. 896 88

Four patients with xanthogranulomatous pyelonephritis were found to have renocolic fistulae. Coincidentally, the left kidney was involved in all four cases. All patients presented with renal mass. Two cases have had coexistent renal stones, one of them presented with massive upper gastrointestinal bleeding as a result of portal hypertension. Another patient had a history of Schistosomiasis. In none of the patients was the renal condition confidently diagnosed preoperatively, nor was the colonic fistula suspected. In all four patients, nephrectomy was performed together with resection of the involved colon followed by a satisfactory recovery. The possibility of a colonic fistula should be kept in mind as a complication to this rare renal condition in spite of the absence of colonic symptoms and normal finding in barium enema studies.
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PMID:Renocolic fistula as a complication to xanthogranulomatous pyelonephritis. 926 78