1/35. ultrasonography of flank pain in the emergency department: renal cell carcinoma as a diagnostic concern.Acute flank pain is a common emergency department presenting symptom, and bedside ultrasound is being used increasingly in its evaluation. Emergency renal ultrasonography concentrates on the focused presence or absence of hydronephrosis as is often seen in patients with acute flank pain secondary to renal colic. We present three cases in which other abnormal sonographic signs not commonly taught prompted further investigation, revealing renal cell carcinoma. Baseline knowledge of sonographic characteristics of tumors will benefit the occasional emergency patient who has unsuspected renal carcinoma.- - - - - - - - - - ranking = 1keywords = flank pain, flank (Clic here for more details about this article) |
2/35. Renal infarction: an uncommon mimic presenting with flank pain.A 39-year-old woman arrived to the emergency department complaining of a constant, progressive, left flank pain, with no beneficial effect from spasmolytic and nonsteroidal antiinflammatory drugs. Two years before, she suffered another episode of right flank pain and stranguria, but instrumental examinations (ultrasonography, urography) remained negative. Besides a mild tenderness in the left flank, physical examination was normal. blood chemistry panel showed leukocytosis (17.2 x 10(3) mL, neutrophils 82.8%) and a slight increase of serum lactate dehydrogenase (LDH) (543 U/L versus 230 to 460 U/L). Urinanalysis showed a slight hemoglobinuria (0.5 mg/dL), and sediment contained some red cells and leukocytes. Diagnostic examinations (ultrasonography, computed tomography) showed a left renal nonhomogeneous space-occupying lesion, orientative for renal malignancy. She was transferred to the urology department and operated. Both intraoperatory and histological diagnosis was ischemic infarction and, after exclusion of all possible underlying causes, final diagnosis was idiopathic renal infarction. Diagnostic procedures and literature reports are discussed.- - - - - - - - - - ranking = 1.0193731115833keywords = flank pain, flank (Clic here for more details about this article) |
3/35. Persistent flank pain, low-grade fever, and malaise in a woman treated with indinavir.This case report describes a 32-year-old woman treated with indinavir who developed mild to moderate flank pain, malaise, and low-grade fever. Sterile pyuria preceded increased serum creatinine levels. Workup revealed persistent pyuria, normal-sized kidneys, a normal intravenous pyelography, and negative urinary cultures. Renal biopsy showed interstitial nephritis and chronic inflammation. Collecting ducts contained crystals. Two months after treatment with indinavir was discontinued, serum creatinine levels returned to normal and pyuria disappeared. Sterile pyuria in patients taking indinavir may help to identify patients at risk for renal dysfunction and interstitial nephritis. Markedly increasing the fluid intake above the recommended dosage may ameliorate or even reverse the process of tubulointerstitial disease.- - - - - - - - - - ranking = 0.83333333333333keywords = flank pain, flank (Clic here for more details about this article) |
4/35. Spontaneous renal hemorrhage.This report of 9 cases of spontaneous renal hemorrhage illustrates the wide variety of responsible conditions that may be found in a small series and the tendency for some of these conditions to coexist. In particular, all 3 patients with a bleeding diathesis had an associated anatomic lesion, and it was concluded that this group of patients required aggressive radiologic investigation. Three main clinical presentations were identified: sudden severe flank pain, symptomless hypertension, and a palpable mass with few or no symptoms. The radiologic signs are reviewed with emphasis on a recently described sign of streaky retroperitoneal fat. Treatment is discussed briefly.- - - - - - - - - - ranking = 0.16666666666667keywords = flank pain, flank (Clic here for more details about this article) |
5/35. Extreme lateral ruptures of lumbar intervertebral discs.Several cases are presented of extreme lateral rupture of the lumbar intervertebral disc in which symptoms of localized nerve root compression were not manifest and in which myelography was negative or misleading. Ordinary exploration techniques failed to disclose these lesions. The most striking pain patterns seen in these patients were flank pain, gluteal, groin, and sometimes upper anterior thigh pain, induced or aggravated by back motion. This pain, plus radiating leg pain, when it occurred, was generally exceedingly severe and disproportionate to the neurological deficit. Lumbar discography was useful in detecting these ruptures.- - - - - - - - - - ranking = 0.16666666666667keywords = flank pain, flank (Clic here for more details about this article) |
6/35. Radiculitis distress as a mimic of renal pain.It is the experience of the urological author that radiculitis secondary to costovertebral joint derangement is the most common cause of lower abdominal pain. However, this pain is sometimes made worse when the patient is subjected to a flank incision for presumed renal disease, since the aftermath of a flank incision may be a downward pull on a rib owing to detachments of muscles attached to its superior surface. Emotional problems, too, befall many patients with radiculitis-despondency over delayed diagnoses or sensitivity at having been told their complaints are psychosomatic. Most often theses difficulties disappear spontaneously once the pain is relived. Definitive diagnosis requires orthopedic techniques. Unfortunately, few orthopedists are well versed or interested in the syndrome of renal pain. When they are, erroneous diagnosis can be corrected and a course of conservative or surgical treatment prescribed, with excellent results.- - - - - - - - - - ranking = 0.038746223166522keywords = flank (Clic here for more details about this article) |
7/35. renal colic and torsion: case report and review.Acute ureteric colic and acute scrotum are among the most commonly seen urological emergencies. We present a case in which a male patient presented with simultaneous right flank pain and ipsilateral scrotal pain.- - - - - - - - - - ranking = 0.16666666666667keywords = flank pain, flank (Clic here for more details about this article) |
8/35. Renal autotransplantation in the loin pain-hematuria syndrome: a cautionary note.The current literature suggests that renal autotransplantation is nearly uniformly effective in controlling the severe and debilitating pain of the loin pain-hematuria syndrome (LPHS). However, we report two patients thought to have this syndrome in whom renal autotransplantation did not result in long-term control of pain. In case 1, autotransplantation resulted in immediate cessation of pain; however, the flank pain recurred 7 1/2 months later. The recurrent pain was also severe and debilitating, requiring narcotic medications for control. In case 2, autotransplantation of the left kidney resulted in chronic pain in the left pelvic area, the site of the autotransplanted kidney. In addition, the patient continued to experience chronic discomfort in the left flank and along the flank incision. One year after autotransplantation, the patient still requires multiple daily doses of narcotic medications for pain control. Our two patients represent the 13th and 14th reported patients subjected to renal autotransplantation for management of LPHS. They represent only the third and fourth reported patients with recurrence of pain after renal autotransplantation. Because studies with negative results are less likely to be reported in the literature than studies with positive results, it is possible that the literature overestimates the effectiveness of renal autotransplantation in the LPHS. To assess the true effectiveness of renal autotransplantation in LPHS, a survey of patients with LPHS who have undergone renal autotransplantation needs to be performed.- - - - - - - - - - ranking = 0.20541288983319keywords = flank pain, flank (Clic here for more details about this article) |
9/35. Post-pyeloplasty flank pain treated with laparoscopically-assisted renal autotransplantation.Despite excellent overall results, some patients continue to experience flank pain post-pyeloplasty. For the first time, we report the successful use of laparoscopically-assisted renal autotransplantation in the treatment of refractory flank pain post-pyeloplasty.- - - - - - - - - - ranking = 1keywords = flank pain, flank (Clic here for more details about this article) |
10/35. An adolescent girl with Meyer-Betz syndrome.Idiopathic paroxysmal rhabdomyolysis indicating a classical triad of symptoms consisting of muscle pain, weakness, and discolored urine is known as "Meyer-Betz syndrome". It may result in acute renal failure due to precipitation of the myoglobin casts in the tubuli or to the direct toxic effects of myoglobin to the tubular epithelium. On the other hand, outcome may be uneventful. In this study, we reported the case of a 16-year-old girl who was admitted with red-colored urine after a slight exertion. She had tenderness and weakness in upper parts of her legs and bilateral flank pain. She had a positive urine dipstick test for heme despite absent red cells on microscopic examination. White cell count, liver function tests, serum creatine kinase (CK), lactate dehydrogenase (LDH), and urine myoglobin levels were raised. All metabolic tests were in normal ranges and EMG was normal. A muscle biopsy performed after recurrent exertional rhabdomyolysis attacks demonstrated normal findings and ruled out metabolic disorders. At the time of attacks, hydration along with alkalinization was applied and she did not experience renal failure. She was advised to avoid strenuous physical exertion and had an uneventful outcome for the last 5 months. We reported the clinical course and follow-up of an adolescent girl with Meyer-Betz syndrome.- - - - - - - - - - ranking = 0.16666666666667keywords = flank pain, flank (Clic here for more details about this article) |
| | Next -> |