Cases reported "Hematuria"

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1/72. diagnosis and management of primary hyperoxaluria type 1 in infancy.

    We report a case of a 6-month-old infant who presented with failure to thrive due to end-stage renal disease as a result of primary hyperoxaluria type 1. The infant was managed with a combined daily hemodialysis and peritoneal dialysis prescription in order to manage the total body oxalate burden. Medical management included oral pyridoxine, aggressive hydration and nutritional supplementation via an enteral feeding tube. At one year of age the infant underwent a combined liver/kidney transplantation with intra- and daily post-operative hemodialysis to prevent oxalate deposition in the newly transplanted organs. The post-operative course was complicated by gross hematuria and increased hyperoxaluria, requiring an increase in hydration and thiazide diuretics. This infant received a combination of dialysis modalities which was designed to lower the potential oxalate burden prior to transplantation. This case illustrates the difficulty in medical management of an infant pre- and post-combined liver/kidney transplantation.
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2/72. Subcapsular hemorrhage of adult Wilms' tumor.

    Wilms' tumor is a rare malignancy of kidney in adults. It usually cannot be differentiated from other renal masses preoperatively. This is a presentation of a case of adult Wilms' tumor who developed spontaneous hemorrhage during radiological evaluation. As tumor rupture can change the stage of the tumor and alter the prognosis of the patient, urgent work-up and treatment is advised.
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3/72. Endovascular stent graft for management of ureteroarterial fistula after orthotopic bladder substitution.

    We describe the first case of an ureteroarterial fistula developing after orthotopic neobladder substitution and its minimally invasive management using endovascular stent grafting. We outline the risk factors for the development of ureteroarterial fistulae and trace the evolution of diagnostic and therapeutic modalities used in the management of these life-threatening complications. Minimally invasive management with endovascular stent grafting and exclusion of two pseudoaneurysms in the iliac artery system was performed successfully. After successful endovascular exclusion of two pseudoaneurysms, the patient's hematuria resolved and he recovered fully. Three-dimensional computed tomography performed 3 months later documented a patent aortoiliac arterial system without evidence of pseudoaneurysm or endovascular leak. Ureteroarterial fistula after orthotopic bladder substitution was managed with an endovascular stent graft without the need for extra-anatomical vascular bypass. Early recognition, stabilization, and angiographic evaluation followed by this minimally invasive technique may avoid open operative repair and attendant morbidity.
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4/72. pheochromocytoma of the urinary bladder presenting only with macroscopic hematuria.

    pheochromocytoma of the bladder is an unusual tumor that typically presents with hypertensive crises related to micturition. We describe a case of bladder pheochromocytoma in a 42-year-old female in which macroscopic hematuria was the only alarming symptom. The diagnostic and operative issues of this type of tumor are discussed, along with the challenging treatment option of transurethral resection. diagnosis, treatment and follow-up trends of this rare tumor are reviewed.
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5/72. Selective embolization of a renal artery aneurysm.

    The treatment modalities for renal artery aneurysm have changed. The aim in the presented case was to evaluate the endovascular therapy in a 52-year-old woman (with hematuria as the only symptom) with a saccular aneurysm at the first bifurcation of the right main renal artery, which was diagnosed with contrast-enhanced computerized tomography and angiography. We approached the aneurysm with minimally invasive supraselective embolization. There were no postoperative complications, as confirmed with control angiography, during the intervention and after an interval of 4 weeks. In conclusion, selective coil embolization as first-line therapy to treat saccular renal artery aneurysm is feasible. In this case, minimally invasive procedure provided maximum functioning kidney tissue.
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6/72. Segmental multicystic dysplastic kidney in an adult woman.

    We report a case of unilateral segmental multicystic dysplastic kidney (SMCDK) in an adult woman. A 42-year-old woman presented with abdominal distension and gross hematuria. The preoperative diagnosis was cystic renal cell carcinoma, and a radical nephrectomy was performed. Histopathologically, the resected kidney was SMCDK with severe hydronephrosis.
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7/72. A case report on vesico-uterine fistula: a very rare complication of the lower caesarean section.

    Vesico-uterine fistula is a very rare complication of lower caesarean section. There has only been two cases seen at the Department of urology in the past 2 decades. patients usually present in the early post operative period with the problem of continuous urinary incontinence. On the rare occasion, recurrent urinary tract infection, recurrent gross painless haematuria, or secondary infertility associated with secondary amenorrhoea would be the presenting complaint.
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8/72. Spontaneous thrombosis of an iatrogenic arteriovenous fistula of the kidney.

    A 44-year-old woman underwent radial nephrotomy for a symptomatic stone in a caliceal diverticulum. Five days after an uneventful postoperative course of 1 week, she presented with gross hematuria. Routine ultrasound demonstrated a hypoechoic lesion in the kidney; color-coded sonography revealed an arteriovenous fistula. The hematuria ended before the scheduled angiography to embolize the fistula was performed. Repeated color-coded sonography revealed spontaneous thrombosis of the lesion. The follow-up examination 6 months later confirmed these findings. As traumatic arteriovenous fistulas have a good chance of spontaneous closure, invasive treatment should be postponed for as long as possible.
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9/72. hematuria caused by atheromatous embolism: report of a case diagnosed intravitam.

    Gross, painless hematuria as the only symptom in a 53-year-old male diabetic necessitated partial nephrectomy and was then found to have been caused by atheromatous embolism associated with recent infarction of the renal parenchyma. This case appears to be the first one reported in which the diagnosis of renal atheromatous embolization had been established intravitam. A similar episode of hematuria occurred a year postoperatively and another renal infarction, likely caused by atheromatous embolization, was demonstrable with tomographic and angiographic techniques.
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keywords = operative
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10/72. Arterial pseudoaneurysm complicating endoscopic fulguration of upper urinary tract urothelial carcinoma.

    We report a case of intrarenal arterial pseudoaneurysm after ureteroscopic fulguration of recurrent urothelial carcinoma. An asymptomatic 90-year-old woman underwent uneventful cauterization of two small papillary urothelial carcinomas. One month postoperatively, the patient presented with gross hematuria. Angiographic evaluation revealed a small pseudoaneurysm in the distal upper pole branch of the left renal artery, corresponding to the site of recent tumor fulguration. Angioembolization of this lesion was successfully performed. Acute or subacute gross hematuria after endoscopic tumor ablation may be due to an arterial pseudoaneurysm. Angiographic evaluation is critical for the successful diagnosis and treatment of this complication.
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