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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous cutaneous fistulae and abscesses of the renal pelvis and ureter have become rare. Six case reports demonstrate their etiology and differential diagnostic problems. If there is no underlying urologic disease, above all no urolithiasis, other causes of fistulae and abscesses should be kept in mind, the most frequent of these being Crohn's disease.
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PMID:[Spontaneous fistulae and abscesses of the upper urinary tract (author's transl)]. 50 87

Oxalate-urolithiasis and hyperoxalaria have been reported to be a frequent complication in patients with small bowel disease, especially in patients with ileal resection due to Crohn's disease. Hyperabsorption of oxalate seems to be the main patholgenetic factor for "enteric" hyperoxalaria. Intestinal absorption and urinary excretion of oxalate was measured in patients with various gastrointestinal diseases after oral or rectal administration of 14C-oxalate. Kinetic data suggest that 14C-oxalate is absorbed in the small, the large bowel and the rectum as well. Oxalate absorption was decreased in patients with a colectomy and in active ulcerative colitis, but increased in patients with ileal resection, chronic liver disease, and steatorrhea due to chronic pancratitis or sprue. There existed a positive correlation between 14C-oxalate absorption and the amount of fecal fat excretion. The data suggest that hyperoxaluria and hyperabsorption of oxalate are not a specific finding in patients with bile acid malabsorption, but may occur too, in steatorrhea without alteration of bile acid metabolism.
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PMID:[Enteric hyperoxaluria. I. Intestinal oxalate absorption in gastrointestinal diseases (author's transl)]. 68 26

Excretion of oxalic acid in urine was measured in 28 healthy and 97 patients with gastrointestinal diseases. We found significantly higher values in the following groups: patients after resection of parts of the small intestine, patients with sprue and other diseases with malabsorption, patients with M. Crohn of the small intestine, colitis ulcerosa and granulomatosa, patients with chronical diseases of the pancreas gland and patients with cirrhosis of the liver. In 4 patients after resection of parts of the small intestine or pancreas urolithiasis could be verified. Reduction of fat and food without ballast reduced the excretion of oxalic acid in urine. Hyperoxaluria correlied significantly with the following parameters: excretion of fat in feces, exhalation of 14CO2 in the glykocholate breath test, resorption of vit. B12 and the length of resected small intestine. This form of hyperoxaluria is caused by hyperresorption of oxalic acid from food. The mechanism of this hyperresorption is not clarified yet, an important factor seems to be ill resorption of fat.
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PMID:[Hyperoxaluria in intestinal and liver diseases]. 83 13

Urinary oxalate excretion was measured in healthy persons and patients with Crohn's disease, colitis ulcerosa, sprue and other diseases accompanied with malabsorption, and patients with insufficiency of the exocrine pancreas gland. Further measurements were made in patients after resection of parts of the small intestine or the colon. We found a clear increase of urinary oxalate excretion in patients with resected parts of the small intestine, sprue or other malabsorption syndromes. In 4 patients with resected parts of small intestine or pancreas we even found urolithiasis. Urinary oxalate excretion correlated significantly with steatorrhoea and increased if larger parts of small intestine were resected. Increased resorption of oxalate from food causes increased urinary excretion. Details about the patho-mechanism of this increased excretion are not known yet; an important factor seems to be the reduced absorption of fat in the small intestine.
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PMID:[Hyperoxaluriaas a complication of intestinal diseases (author's transl)]. 99 43

Excretory urography was performed in 55 patients with non-specific ulcerative colitis and Crohn's disease with colonic involvement. The kidney pathology was revealed in 47.3% of the patients, in 5 (27.8%) of 18 patients examined before the operation, and in 21 (56.8%) of 37--after extensive colonic resection. Nephroptosis, urolithiasis, hydronephrosis, pyelocystitis were the main complications.
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PMID:[Clinico-radiologic features of the kidneys in patients with nonspecific colitis]. 234 53

A 34 year-old man, who had been under care with diagnosis of Crohn's disease in the department of gastroenterology of our hospital since 1983, was referred to our urological clinic on May 21, 1987, because of right hydronephrosis found on ultrasonography. He did not complain of any urological symptoms. He underwent further roentgenographic examinations and a diagnosis of hydronephrosis complicated with Crohn's disease was made. On surgery of July 30, resection of ileocecal lesion, end-to-end ileocolostomy, right ureterolysis were performed. He is now visiting our clinic without recurrence of hydronephrosis up to present (7 months). In addition, we reviewed the 41 cases of urological disorders complicated with Crohn's disease in the literature reported in Japan. The cases were of vesicoenteric fistula including pericystitis (33 cases), hydronephrosis (10 cases), urolithiasis (2 cases) and ureterocolonic fistula (1 case). The patients were from 10 to 57 years (27.2 years in average) old. Sex distribution was uneven, 39 of patients were men and 2 were women. Urologic surgery was performed in almost all of the cases except for the patient with urolithiasis. All the patients having vesicoenteric fistula had urological complaints but the patients with hydronephrosis were relatively free from urological complaints. Thus, Crohn's disease has been recognized as an important gastrointestinal disease for urologists, and we will emphasize that periodical abdominal ultrasonography and urography for the patients with this disease should be necessary for checking up other complications such as hydronephrosis.
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PMID:[Hydronephrosis caused by Crohn's disease: a case report--review of 41 cases with urinary tract complication reported in Japan]. 267 65

Conventional treatment of enteric hyperoxaluria (EHO) consists of dietary restriction of oxalate and fat and correction of its underlying cause whenever possible. Recent work suggests that allopurinol reduces the incidence of urolithiasis and the urinary excretion of both oxalate and uric acid in patients without intestinal disease. We have assessed the effect of allopurinol, 300 mg daily for 2 weeks, on urine biochemistry in patients with EHO due to small bowel Crohn's disease and/or resections. Compliance with treatment was confirmed by a fall in plasma uric acid in every patient. Allopurinol failed to alter 24 h urinary oxalate excretion or oxalate concentration. There were also no significant changes in the urinary excretion of glycollate (like oxalate, a breakdown product of glyoxylate), citrate, magnesium or calcium, each of which was at the lower end of the normal range before and during treatment with allopurinol. It appears unlikely that allopurinol will prove useful in the prevention of urolithiasis in patients with EHO.
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PMID:Failure of allopurinol to modify urinary composition in enteric hyperoxaluria. 280 58

The course of all 113 patients with Crohn's disease whose initial procedure involved an anastomosis operated upon from 1942 to 1972 was followed through 1980. The calculated cumulative 30-year total mortality was 23.4%, 16.7% disease-related. The cumulative recurrence rate was 29% at five years, 52% at ten years, 64% at 15 years and 84% at 25 years, with no important differences between disease locations and types of operation. Sex, age, duration, granulomas, enteral or perirectal fistulas and length of the resection, the disease, and the proximal resection margin had no significant influence on the rates of development of recurrent disease or on functional outcome. By far the most common site of recurrence was the neo-terminal ileum, but in ileocolitis compared with ileitis, recurrence was 5.2 times more likely (p = 0.0001) to involve the adjacent or remote colon as well. Moreover, only 1/63 ileitis patients eventually required ileostomy, whereas 15/47 patients with ileocolitis or colitis ultimately required this procedure (p less than 0.001). The current status of the patients was excellent or good in 64% and unwell or dead related in 24%. Urolithiasis developed in 19%.
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PMID:The long-term outcome of restorative operation in Crohn's disease: influence of location, prognostic factors and surgical guidelines. 711 39

The prevalence of urinary stones in a group of subjects living with a permanent ileostomy has been determined by intravenous urography. Thirty-nine of the ileostomists had previously suffered from ulcerative colitis, while the remaining 12 suffered from Crohn's disease. Four of the ileostomists who had had ulcerative colitis had urinary stones (10.3 per cent). These four subjects were all male, so that among the 23 male ileostomists who had had ulcerative colitis 17.4 per cent had urinary stones. No urinary stones were found in the ileostomists with Crohn's disease. Various factors thought to be associated with a liability to urolithiasis have been examined in the ileostomists and also in a control group of 39 healthy subjects matched for age and sex with the ileostomists who had had ulcerative colitis. The ileostomists commonly showed a reduced urinary volume, a low urinary sodium and magnesium content and low urinary pH. The ileostomists were much more prone to be hyperuricaemic than the controls, and hyperuricaemia was strongly associated with the presence of urinary stones.
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PMID:Urinary stones in subjects with a permanent ileostomy. 712 51

We report a case of urolithiasis caused by surgical treatment for Crohn's disease. A 28-year-old woman was referred to our department for further examination of renal stones from the medical department in September, 1995. She suffered from Crohn's disease and had a history of jejuno-ileal resection because of perforation of the ileum in 1988. Radiographs revealed multiple bilateral renal stones, and the urine oxalate concentration was elevated. She was treated with extracorporeal shock wave lithotripsy and the administration of sodium bicarbonate and citrate, but these treatments did not prevent recurrence and enlargement of stones. Renal function was gradually worsened and we performed transurethral lithotomy and percutaneous nephrolithotripsy. The stones were mainly composed of oxalate calcium monohydrate. A renal biopsy was performed at the operation, showing deposition of crystals in almost all renal tubules. Diet therapy (low oxalate and low fat) and the administration of sodium bicarbonate and citrate were performed strictly and recurrence was not recognized 10 months after complete removal of the stones.
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PMID:[Urolithiasis associated with Crohn's disease: a case report]. 985 Aug 37


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