1/135. Ureteropelvic junction obstruction presenting as early satiety and weight loss.We present a case of ureteropelvic junction (UPJ) obstruction which had the unusual presentation of early satiety and weight loss secondary to gastric compression by a distended renal pelvis. The patient was treated successfully with percutaneous antegrade endopyelotomy.- - - - - - - - - - ranking = 1keywords = junction (Clic here for more details about this article) |
2/135. Geriatric ureteropelvic junction obstruction: the possible role of an arteriosclerotic lower pole branch of renal artery: report of two cases.An 83-year-old woman presented with left flank pain and high grade fever. After left ureteral catheterization and intensive chemotherapy with hemoperfusion, surgical exploration revealed the lower pole branches of the renal vessels were obstructing the ureteropelvic junction (UPJ), and dissection of the vessels released the obstruction. An 82-year-old man presented with right flank pain. angiography demonstrated UPJ obstruction caused by the lower pole branch of the renal artery. Arterial dissection with dismembered pyeloplasty resulted in improvement of obstruction. In both cases, the patients had a long history of hypertension with mild to severe arteriosclerosis. arteriosclerosis associated with fixation of the UPJ, may be one of the important factors leading to progressive hydronephrosis in geriatric patients.- - - - - - - - - - ranking = 1keywords = junction (Clic here for more details about this article) |
3/135. Dismembered pyeloplasty followed by metachronous ureteropelvic junction obstruction in the contralateral kidney.hydronephrosis due to congenital ureteropelvic junction obstruction (UPJO) is commonly diagnosed by antenatal sonography. We report the case of an infant who developed new-onset hydronephrosis in the right kidney following uneventful left-sided pyeloplasty for a congenital UPJO. The furosemide minus 15-minute diuretic renogram (F-15 DR) was used to confirm obstruction in the affected renal unit when standard diuretic renography was equivocal. The indications for surgery or observation as well as the role of the F-15 DR are discussed.- - - - - - - - - - ranking = 1keywords = junction (Clic here for more details about this article) |
4/135. Silent hydronephrosis/pyonephrosis due to upper urinary tract calculi in spinal cord injury patients.STUDY DESIGN: A study of four patients with spinal cord injury (SCI) in whom a diagnosis of hydronephrosis or pyonephrosis was delayed since these patients did not manifest the traditional signs and symptoms. OBJECTIVES: To learn from these cases as to what steps should be taken to prevent any delay in the diagnosis and treatment of hydronephrosis/pyonephrosis in SCI patients. SETTING: Regional spinal injuries Centre, Southport, UK. methods: A retrospective review of cases of hydronephrosis or pyonephrosis due to renal/ ureteric calculus in SCI patients between 1994 and 1999, in whom there was a delay in diagnosis. RESULTS: A T-5 paraplegic patient had two episodes of urinary tract infection (UTI) which were successfully treated with antibiotics. When he developed UTI again, an intravenous urography (IVU) was performed. The IVU revealed a non-visualised kidney and a renal pelvic calculus. In a T-6 paraplegic patient, the classical symptom of flank pain was absent, and the symptoms of sweating and increased spasms were attributed to a syrinx. A routine IVU showed non-visualisation of the left kidney with a stone impacted in the pelviureteric junction. In two tetraplegic patients, an obstructed kidney became infected, and there was a delay in the diagnosis of pyonephrosis. The clinician's attention was focused on a co-existent, serious, infective pathology elsewhere. The primary focus of sepsis was chest infection in one patient and a deep pressure sore in the other. The former patient succumbed to chest infection and autopsy revealed pyonephrosis with an abscess between the left kidney and left hemidiaphragm and xanthogranulomatous inflammation of perinephric fatty tissue. In the latter patient, an abdominal X-ray did not reveal any calculus but computerised axial tomography showed the presence of renal and ureteric calculi. CONCLUSIONS: The symptoms of hydronephrosis may be bizarre and non-specific in SCI patients. The symptoms include feeling unwell, abdominal discomfort, increased spasms, and autonomic dysreflexia. physicians should be aware of the serious import of these symptoms in SCI patients.- - - - - - - - - - ranking = 0.2keywords = junction (Clic here for more details about this article) |
5/135. Antenatal hydronephrosis with postnatal resolution: how long are postnatal studies warranted?We present 2 cases of antenatal hydronephrosis with initial normalization of postnatal studies. Both patients experienced late-onset (6 and 22 months) hydronephrosis secondary to ureteropelvic junction obstruction, necessitating surgical intervention. These cases raise questions about the need for late follow-up imaging in patients with apparent resolution of hydronephrosis diagnosed antenatally.- - - - - - - - - - ranking = 0.2keywords = junction (Clic here for more details about this article) |
6/135. Robot assisted laparoscopic nephrectomy.PURPOSE: The feasibility and safety of remote laparoscopic surgery using a surgical telemanipulator have been demonstrated in laboratory experience and recently in clinical practice. To our knowledge we report the first robot assisted, laparoscopic nephrectomy in a human. MATERIALS AND methods: A 77-year-old woman was diagnosed with a nonfunctioning hydronephrotic right kidney due to ureteropelvic junction obstruction. Robot assisted, transperitoneal right laparoscopic nephrectomy was performed. RESULTS: Complete dissection was successfully performed with the robot. The renal pedicle was dissected without any problem, and the artery and vein were individually ligated. operative time was 200 minutes, anesthesia time was 245 minutes and blood loss was less than 100 ml. convalescence was uneventful. Histological examination confirmed the preoperative diagnosis. CONCLUSIONS: We report the technical feasibility of robot assisted laparoscopic nephrectomy in humans. Current technology needs further improvement and its actual usefulness for patient treatment must be established by large clinical trials. Technological improvements and future telecommunication networks should open new avenues in surgery, namely remote telesurgery.- - - - - - - - - - ranking = 0.2keywords = junction (Clic here for more details about this article) |
7/135. Ureteropelvic junction obstruction due to inflammatory pseudotumor masquerading as hydronephrosis because of a neuropathic bladder in a child with myelomeningocele.Inflammatory pseudotumors (IPTs), also known as inflammatory myofibroblastic tumors, are rare solid lesions, generally thought to be benign, which have been described in a variety of locations. We report a case of a child with a neuropathic bladder who developed a pseudotumor of the retroperitoneum that caused progressive ureteral obstruction distal to the ureteropelvic junction. hydronephrosis as a complication of IPTs has been described with bladder and uterine IPTs; however, in our review of published reports, we found no reported cases of a retroperitoneal IPT causing proximal ureteral obstruction in a pediatric patient.- - - - - - - - - - ranking = 1keywords = junction (Clic here for more details about this article) |
8/135. Pyeloureteral junction stenosis and ureteral valve causing hydronephrosis.A young female patient underwent ureteral resection and Hynes-Anderson pyeloureteroplasty because of pyeloureteral junction stenosis and a ureteral valve (UV), which caused hydronephrosis. Despite using ultrasonography and intravenous urography the ureteral valve was observed only on exploration. UV should be considered as a possible cause of upper urinary tract obstruction; retrograde urography can be essential.- - - - - - - - - - ranking = 1keywords = junction (Clic here for more details about this article) |
9/135. Development of a large bladder calculus on sutures used for pubic bone closure following extrophy repair.bladder exstrophy is a rare congenital condition that occurs in 1 to 30,000 live births. Primary bladder closure is usually performed in the first days of life in conjunction with an iliac osteotomy in order to achieve a more secure bladder closure. We report a case of a large bladder stone with secondary right-sided hydronephrosis in a 3-year-old child who underwent exstrophy repair at the age of 7 months. During the exstrophy repair a no. 1 braided, polyester, non-absorbable suture was used to close the pubic bones and served as a nidus for intravesical stone formation. This case substantiates the lithogenic nature of non-absorbable sutures in contact with urine as well as the need for close post-operative follow-up in these patients.- - - - - - - - - - ranking = 0.2keywords = junction (Clic here for more details about this article) |
10/135. renal artery aneurysm causing hydronephrosis.A 42-year-old man presented with left hydronephrosis incidentally discovered on abdominal echogram during a routine health examination. color Doppler ultrasonography, intravenous pyelography and angiography revealed a non-calcified renal artery aneurysm of 30 mm in size compressing the pyeroureteral junction and causing hydronephrosis. Three-dimensional computed tomography (3-D CT) using spiral CT clearly displayed the aneurysm located at the first bifurcation of the left renal artery and involving the anterior segmental artery. decompression was successfully obtained via in situ revascularization of the renal artery after aneurysmectomy. A literature search revealed 12 cases of renal artery aneurysm causing hydronephrosis reported in japan, although only three cases were documented in other countries, and these reports are reviewed. Use of 3-D CT for evaluation of renal artery aneurysm is advocated.- - - - - - - - - - ranking = 0.2keywords = junction (Clic here for more details about this article) |
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