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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In severe obstructive disease of the kidney, with major distension of the intrarenal collecting ducts and marked thinning of the parenchyma, intravenous urography with high doses of contrast medium may reveal, almost pathognomic nephrographic abnormalities, such as, the dense capsule appearance, or septal appearances. The diagnostic value of these radiological appearances is all the greater in these very advanced cases of hydronephrosis, opacification of the excretory ducts can often not be obtained.
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PMID:[The capsule sign in severe hydronephrosis (author's transl)]. 115 19

A case is presented in which extreme hydronephrosis simulated absence of the right kidney. The hydronephrosis occurred as a result of surgical ligation of the right ureter 10 years previously. There was no visualization of the excretory system by intravenous urography or retrograde pyelography. Abdominal aortography did not show the renal artery. Selective renal venography revealed a patent venous bed with splaying and thinning of the intrarenal veins. The contribution of renal venography is discussed in clarifying cases in which the kidney and the renal artery were not visualized.
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PMID:Selective renal venography in the evaluation of a non-functioning hydronephrotic kidney. 120 36

Idiopathic retroperitoneal fibrosis leading to obstructive uropathy is a rare disease in our country, so a typical case deserves presentation. The patient is a 56-year-old female to have a clinical manifestation of obstructive uropathy. Retrograde pyelogram permitted 5 Fr. ureteral catheter to pass the stenotic segment. At the mean-time, there was hydronephrosis, medial deviation and gradual thinning and pointing of the middle segment of the ureter (classic triad). Computed tomography revealed that retroperitoneal soft tissue plaque enveloped aorta, inferior vena cava, and bilateral ureters. The patient received ureterolysis with ureter intraperitonealization and lateralization. The plaque was pathologically proved fibrosis. Renal function became normal postoperatively.
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PMID:[Idiopathic retroperitoneal fibrosis causing obstructive uropathy: a case report]. 165 31

Since pyelocalicectasis alone is common in fetuses, we reviewed reports of fetal hydronephrosis that resolved spontaneously or at birth. Severe fetal hydronephrosis with calicectasis or parenchymal thinning rarely resolves spontaneously before or after birth. We also reviewed the clinical and experimental literature on renal hypertrophy. After unilateral nephrectomy in neonatal animals or after birth with congenital absence of one kidney in humans, the remaining kidney hypertrophies very quickly. In infants and young animals, the eventual size of the remaining kidney is inversely proportional to the age at which one kidney is lost. This improvement in residual renal function seen after renal loss in infancy, compared with older children, itself constitutes a strong argument for early relief of obstruction. If contralateral renal hypertrophy has occurred, the treated damaged kidney may resume growth in parallel with its hypertrophied mate but does not become as large or recover normal potential for growth. In other words, if correction of a unilateral obstruction is deferred until contralateral hypertrophy occurs, the obstructed kidney then has less potential for recovery of function.
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PMID:Natural history of fetal and neonatal hydronephrosis. 218 53

An experimental study of bladder tolerance to intraoperative radiotherapy (IORT) was designed using a large animal model (adult American Foxhounds, weight 25-30 kg) to access acute and late radiation effects. Dogs were subjected to laparotomy where the bladder was mobilized and IORT was delivered using a 5 cm circular cone through a cystotomy incision with 12 MeV electrons. The bladder trigone including both ureteral orifices and the proximal urethra was irradiated in groups of 3 dogs with doses of 0, 20, 25, 30, 35, and 40 Gy. Dogs were followed clinically with repeat urinalysis, intravenous pyelogram (IVP), and cystometrogram at 1 month and then Q6 months for up to 4 years. One dog from each dose group was sacrificed electively at 1 and 2 years, whereas the other dog is being followed clinically for a minimum of 4 years. Complete autopsies were performed with particular attention to genitourinary and pelvic structures. No clinically detectable acute toxicity resulted from IORT to the bladder. Three of 15 IORT dogs (1 each at 25, 35, and 40 Gy) showed obstruction of a ureteral orifice with 2 dogs dying of renal failure secondary to bilateral hydronephrosis within 1-2 years of treatment. The remaining 12 IORT dogs and 3 control dogs have normal repeat IVP's and renal function with up to 4 years of follow-up. Serial cystometry demonstrates no major loss of bladder contractility or volume. At autopsy, histological changes of mucosal thinning and telangiectasia with submucosal fibrosis were confined to the IORT field and appeared dose-related. However, the bladder epithelium remained intact at all doses. The ureterovesical junction in animals receiving 20 Gy showed mild fibrosis of the lamina propria and moderate chronic inflammation. Above 20 Gy, these histological changes at the U-V junction were more pronounced with gross stenosis in 3 animals as predicted by the IVP. We conclude that the bladder trigone will tolerate IORT to 20 Gy without major clinical sequellae. Above 20 Gy, progressive inflammation and fibrosis of the U-V junction resulted in obstructive hydronephrosis in three animals within 1-2 years of IORT. The bladder mucosa remained intact with doses to 40 Gy, although submucosal fibrosis and chronic inflammation were evident and appeared dose-related. However, bladder function as measured by cystometry showed essentially no change with follow-up to 4 years. From this large animal study, IORT for early-stage bladder carcinoma is technically feasible and deserves a careful clinical study.
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PMID:Tolerance of the canine bladder to intraoperative radiation therapy: an experimental study. 312 84

A case of double inferior vena cava associated with congenital hydronephrosis is reported. A 6-year-old girl was referred to our hospital with the chief complaint of severe left flank pain of sudden onset which occurred after she fell down some steps. Abdominal computerized tomographic (CT) scan revealed a huge perinephric urinoma, severe left hydronephrosis with obstructive atrophy and double inferior vena cava. Left nephrectomy was performed under a diagnosis of traumatic rupture of the left renal pelvis associated with left congenital hydronephrosis and double inferior vena cava. Rupture of the renal pelvis and ureteropelvic junction obstruction with severe parenchymal thinning were found. The postoperative course was uneventful. Double inferior vena cava is a relatively rare anomaly and most cases in recent years have been incidentally found by ultrasonography and CT scan. Urologists should keep in mind the possibility of this anomaly of the inferior vena cava, especially when reforming left nephrectomy.
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PMID:[Double inferior vena cava discovered by examination of traumatic rupture of congenital hydronephrotic renal pelvis: a case report]. 846 87

We report a case of sarcomatoid renal cell carcinoma and simultaneous transitional cell carcinoma of the renal pelvis in a 77 year old man admitted for uroseptic fever persisting for two months. Seven years earlier he underwent cystectomy with ureterosigmoidostomy for transitional cell carcinoma of the bladder. CT scan described a severe hydronephrosis with dilated pelvis, several pseudocystic formations with renal parenchima thinning and absence of contrast excretion. Radical nephrectomy was performed consequent to a clinical diagnosis of uroseptic fever in secondary hydronephrosis due to stenosis of ureterosigmoidostomy. Tumors were suspected on cut section and confirmed by histological examination.
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PMID:[Sarcomatoid carcinoma of the kidney associated with urothelial carcinoma: report of a case with unusual clinical presentation]. 1087 65

A case of rupture of giant hydronephrosis due to blunt trauma is reported. A 49-year-old male was admitted to our hospital complaining of right flank pain and gross hematuria after falling from a roof. Radiological evaluation lead to the diagnosis of marked right hydronephrosis with severe parenchymal thinning secondary to ureteral stone, left staghorn calculus and the rupture of right kidney. Right nephrectomy was performed and the postoperative course was uneventful. Three weeks later, percutaneous nephrolithotomy (PNL) was performed for left staghorn calculus. Other articles concerning giant hydronephrosis discovered following trauma are reviewed.
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PMID:[Traumatic rupture of giant hydronephrosis due to ureteral stone: a case report]. 1471 58

A 65-year-old man presented with sudden onset of gross hematuria and urinary retention. Computed tomographic scan (CT) showed a cystic multilocular enhancing lesion (9 cm in diameter) at the left renal hilum causing thinning and lateral displacement of the left renal parenchyma. Left hydronephrosis and a renal calculi were observed. We performed radical nephrectomy suspecting a cystic renal cell carcinoma. Microscopic examination and immunohistochemical studies confirmed the diagnosis of the carcinoid tumor. The tumor cells were fully positive for neuron-specific enolase and keratin, and partially positive for chromogranin-A. One of the resected lymph nodes was positive for metastasis. Additional gastrointestinal tract examinations for carcinoid tumor were negative. However, he was concurrently diagnosed with poorly differentiated prostate cancer and hormonal therapy was started. He is free of recurrent carcinoid tumor nine months postoperatively. This case is the 31st report of renal carcinoid tumors in Japan.
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PMID:[Renal carcinoid tumor presenting as bladder tamponade: a case report and review of the Japanese cases]. 1611 10

Findings of ultrasound examination of the urinary tract and changes in clinical management, which were instituted on the basis of ultrasound examination, were compared between two groups of spinal cord injury patients. Group 1 had no urinary symptoms when they underwent the scan, whereas group 2 was comprised of patients with symptoms pertaining to the urinary tract. Between 2000 and 2006, ultrasound examination of the urinary tract was performed in 87 spinal cord injury patients who had no urinary symptoms when they underwent the ultrasound scan. No abnormality was found in 63 patients. The ultrasound scan showed some abnormality of the urinary tract in 24 patients (simple cyst in the kidney: 4; reduced size of a kidney: 3; increased echogenicity of left kidney: 1; prominent extrarenal pelvis and mild calyceal dilatation: 1; slightly dilated renal pelvis and calyceal system: 1; pelvic kidney showing mild hydronephrosis: 1; foetal lobulation of kidney: 2; multicystic kidney with no interval change in the appearance since last examination: 1; 2-cm-diameter parapelvic cyst: 1; small renal calyceal calculus: 5; a little cortical scarring bilaterally: 1; focal renal scar: 2; generalised thinning of renal cortex: 3; increase in renal sinus fat: 3; trabeculated bladder: 2; small vesical diverticulum: 1; mild generalised bladder wall thickening: 1; small residual urine in postvoid scan; 2). No specific interventions were performed in these patients on the basis of ultrasound findings. In Group 2, ultrasound examination revealed serious abnormalities such as hydronephrosis, pyonephrosis, vesical calculi, vesical polyp in 20 of 21 patients, and all 20 patients required therapeutic intervention on the basis of ultrasound scan findings. In conclusion, routine ultrasound examination of the urinary tract in spinal cord injury patients who have no urinary symptoms may not be justifiable in terms of cost effectiveness; limited hospital resources should be directed to spinal cord injury patients with urinary symptoms so that ultrasound examination and therapeutic interventions based on ultrasound findings are carried out expeditiously.
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PMID:A comparative study of ultrasound examination of urinary tract performed on spinal cord injury patients with no urinary symptoms and spinal cord injury patients with symptoms related to urinary tract: do findings of ultrasound examination lead to changes in clinical management? 1761 17


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