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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We herein report a rare case of peripelvic extravasation due to peritoneal dissemination of pancreatic carcinoma. A 75-year-old female with left flank pain was admitted. Computed tomographic scan demonstrated a huge urinoma medial and posterior to the left kidney, and an irregular mass around the left lower ureter. Retrograde pyelography showed complete ureteral obstruction. The probable diagnosis was spontaneous peripelvic extravasation due to left ureteral tumor or ovarian tumor. Laparotomy revealed a tumor involving the body and tail of the pancreas and some disseminated tumors in the retroperitoneum. Pathological diagnosis was metastatic carcinoma of the pancreas. Malignant tumors in the digestive organs should be taken into consideration in the differential diagnosis of peripelvic extravasation.
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PMID:[Peripelvic extravasation due to peritoneal dissemination of pancreatic carcinoma: a case report]. 989 27

A case of spontaneous peripelvic extravasation with ileocecal cancer is reported. A 60-year-old man with right flank pain was referred to our department. Dripinfusion pyelography showed right peripelvic extravasation. Neither computed tomography (CT) nor retrograde pyelography revealed any ureteral stones or tumors. Urinary cytology was negative. One month later, right retrograde pyelography demonstrated the filling defect in the right ureter, but no stones, ureteral tumors or other tumors related to the ureter were detected by CT. An exploratory laparotomy was done. We found an ileocecal tumor invading to the right ureter and disseminated to the peritoneum. Histological diagnosis was mucinous carcinoma.
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PMID:[Spontaneous peripelvic urine extravasation associated with ileocecal cancer: a case report]. 1008 68

The objective of this study was to determine whether helical computed tomography (CT) performed without oral or intravenous contrast agents is accurate in the evaluation of patients with suspected acute renal colic. One hundred consecutive patients with suspected renal colic or ureteral colic were referred by our institution's emergency department for unenhanced helical CT scans. We reviewed the original radiographic report for each patient and recorded the size and location of ureteral calculi and other concurrent urinary tract calculi, if any. We also recorded the presence or absence of hydronephrosis, hydroureter, perinephric edema, and periureteral edema. A total of 49 patients had ureteral calculi, 17 patients had only renal calculi, and 34 patients had no stones. Forty-nine patients had ureteral calculi, and 40 (82%) of these 49 patients had associated CT signs including hydroureter and periureteral edema. Calculi were present in the proximal ureter in 11 patients, the midureter in seven patients, and the distal ureter including ureterovesical junction in 31 patients. Calculi were seen elsewhere in the urinary tract and renal pelvis in 44 patients. Other diagnostic tests and stone passage were used to confirm the CT diagnosis of ureteral stones. The sensitivity and specificity of helical CT in evaluating ureteral calculi were 100% and 94%, respectively. Sixteen extraurinary lesions were detected in 34 patients who had no urinary calculi. Most extraurinary lesions (81%) were deemed the cause of acute flank pain. The room time for CT averaged 26 min, compared to 69 min for intravenous urography (IVU). The charge for CT was $600 compared to $400 for IVU in our institution. Unenhanced helical CT was fast and accurate in determining the cause of colic and proved to be highly accurate for emergency situations.
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PMID:Can noncontrast helical computed tomography replace intravenous urography for evaluation of patients with acute urinary tract colic? 1019 91

Ureteral obstruction occurred in two patients after laparoscopic Burch cystourethropexy. Both women experienced right flank pain and right hydronephrosis. Cystoscopy revealed transmural passage of suture anterior and lateral to the ureteral orifice on the right side. One patient was managed by suprapubic cystoscopy to release the suture; the other was managed by preperitoneal laparoscopy to release suture at the bladder neck. In both patients efflux of urine was seen immediately from the ureteral orifice after suture release. Ultrasound confirmed prompt resolution of hydronephrosis. Cystoscopy with confirmation of patent ureters should be performed after every case of retropubic cystourethropexy. Retrograde rigid cystoscopy may not afford adequate access to remove transmural sutures. Placement of sutures at the bladder neck from medial to lateral may avoid entrapment of the intramural portion of ureter. (J Am Assoc Gynecol Laparosc 6(2):217-219, 1999)
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PMID:Ureteral compromise after laparoscopic Burch colpopexy. 1022 37

A case of idiopathic retroperitoneal fibrosis is reported. The patient was a 63-year-old man with the complaint of right flank pain, general fatigue and weight loss. Intravenous pyelography revealed right hydronephrosis and peripelvic extravasation. Abdominal computed tomography showed subcapsular urinoma of the right kidney and mass lesion surrounding the aortic bifurcation. Retrograde pyelography demonstrated a narrow segment at the middle portion of the right ureter through which the ureteral catheter could be easily passed. Magnetic resonance imaging showed a low-intensity mass on T1 weighted images and a heterogeneous mass on T2 weighted images. Steroid therapy was selected under the diagnosis of idiopathic retroperitoneal fibrosis with subcapsular urinoma of the right kidney. Prednisolone was administered for 60 days, resulting in the complete disappearance of the urinoma.
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PMID:[A case of idiopathic retroperitoneal fibrosis with renal subcapsular urinoma resolved by steroid therapy]. 1036 44

We present our experience with transabdominal ultrasonographic diagnosis of ureteral tumors. During the years 1989 to 1998, 16 patients were diagnosed as having ureteral tumors. These patients were referred for sonographic examination for evaluation of hematuria (seven patients) or flank pain (four patients) or for follow-up screening in patients who were asymptomatic but at high risk for transitional cell carcinoma because of known past bladder tumor (five patients). Ten of these patients underwent intravenous urography examination, three patients had retrograde pyelography, and 11 patients underwent CT scanning. Ultrasonography revealed the ureteral tumors in all 16 patients, which appeared as hypoechoic intraluminal soft tissue. Three tumors were localized in the upper ureter, four in the middle ureter, and nine in the distal ureter. The degree of ureterohydronephrosis was minimal (two cases), mild (five cases), moderate (eight cases), or severe (one case). Eleven tumors caused local widening of the ureteral diameter. On intravenous urography, four patients had a nonfunctioning kidney, three patients had unexplained ureterohydronephrosis, and three patients showed ureteral filling defects, of which only two had irregular contours. On retrograde pyelography, two patients had filling defects (one of which with smooth margins), and one had a truncated ureter. On CT the tumor was clearly demonstrated in only seven patients. We found that ultrasonography can be a useful diagnostic tool in the workup of ureteral tumors.
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PMID:Sonographic diagnosis of ureteral tumors. 1047 73

A 72-year-old man underwent total cystectomy with single stoma cutaneous ureterostomy for the treatment of transitional cell carcinoma of the bladder. The patient came to the outpatient clinic every 2 weeks to exchange ureteral catheters. Six months after the operation, he was admitted to our hospital again due to edema of bilateral legs, fever, and loss of appetite. The patient had metastasis of intrapelvic and paraaortic lymph nodes associated with cachexia, and was given intravenous hyperalimentation and treatment to control pain. Suddenly, he complained of left flank pain. When the ureteral catheter was removed, massive bleeding occurred from the stomal orifice. A fistula between the artery and ureter was suspected. Six days later, the patient died due to acute renal failure. After his death, retrograde ureterography was performed to confirm the fistula. A fistula was found between the left common iliac artery and left ureter.
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PMID:[A fistula between the common iliac artery and ureter following cutaneous ureterostomy: a case report]. 1050 Sep 59

A case of pyonephrosis with high levels of serum CA19-9 antigen is reported. A 71-year-old woman was admitted with right flank pain. Computed tomography and ultrasonography showed severe hydronephrosis and hydroureter due to a right ureter stone. Laboratory data revealed a high level of serum CA19-9. However, no tumor was found in the pancreas, gallbladder, liver, gastrointenstinal tract or genitourinary tract. Drip infusion pyelography showed a non-functioning pattern of right kidney. Therefore, right nephroureterectomy was performed for right pyonephrosis. Histological examination revealed chronic inflammation. Malignant cells were not seen in the resected specimen. The serum CA19-9 levels before and after operation were 102.9 U/ml and 24 U/ml, respectively, being normal after the operation. Immunohistochemical examination revealed the presence of CA19-9 antigen in the urethelium, indicating its expression in the specimen. To our knowledge this might be the first case of pyonephrosis associated with high levels of serum CA19-9 antigen.
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PMID:[A case of pyonephrosis caused by ureteral stones with elevated serum levels of CA19-9]. 1054 Jul 10

Thirty patients with perirenal and periureteral collections were evaluated. The reasons for these collections were after open surgery on the kidney in 11, open surgery on the ureter in 10, percutaneous nephrostolithotomy in 2, after renal transplantation in 5, and after ureteroscopy in 2. The presenting symptoms and signs included flank pain in 12, urine leakage in 5, fever in 5, masses in the iliac fossa in 5, and flank mass in 3. Ultrasound-guided single-step drainage of these collections was done using 10-12 F catheters. Ultrasound-guided single-step percutaneous nephrostomy (PCN) was done prior to drainage of the collection in seven patients in whom ultrasound revealed back pressure changes in their renal units. Pigtail catheters (7-10 F) were used for PCN. The aspirated fluid was clear urine in 12 cases and turbid in 18. The amount of fluid drained ranged from 150-500 mL immediately after the procedure. We used color Doppler sonography to map the site of puncture. No complications were encountered after drainage. The period of drainage varied from 1 week to 37 days. Further intervention was needed in 12 cases due to development of ureteric stricture in 7, prolonged leakage in 3 (one after transplantation, one after ureterocolic anastomosis, and one after ureterolithotomy), and residual stones in 2. Double-J stenting was done in four cases. We conclude that ultrasound-guided drainage of perirenal and periureteral collections is a safe, rapid, and easy method of treatment and should eliminate the need for exploration to drain these collections. Whenever backpressure exists in the renal unit, ultrasound-guided PCN should be done prior to drainage of the collection.
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PMID:Ultrasound-guided drainage of perirenal and periureteral urine collections. 1070 42

A 32-year-old lady presented with primary infertility and a 1-year history of recurrent left-flank pain. She was found to have left lower ureteric obstruction on intravenous urography. No specific cause for the obstruction could be determined preoperatively. The patient underwent open extraperitoneal surgery to determine the cause and to treat the obstruction. A 4-mm vessel was seen crossing over the ureter at the site of narrowing. It was the persistent umbilical artery traced in continuity from the internal iliac artery. The vessel was resected, and the ureter was reimplanted into the bladder. Extrinsic obstruction of the distal ureter because of aberrant or persistent vessels has been infrequently reported. Such reports predominantly refer to children, and the diagnosis is usually made at laparotomy, frequently following previous failed attempts at endourological management.
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PMID:Lower ureteral obstruction due to a persistent umbilical artery. 1074 5


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