Cases reported "Hydronephrosis"

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11/237. Spontaneous rupture of hydronephrotic kidney during pregnancy: value of serial sonography.

    hydronephrosis during pregnancy is common but rarely results in renal rupture. We report an unusual case of spontaneous rupture of a hydronephrotic kidney during pregnancy. Although we could not predict the renal rupture on the basis of sonographic findings, serial sonography was useful in the early detection and management of the rupture.
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12/237. Laparoscopic removal of a gigantic non-functioning kidney via retroperitoneal access.

    Hugely dilated kidneys can sometimes present as abdominal masses. These kidneys are invariably non-functioning and are managed by nephrectomy. We describe a case of massive kidney containing 12.5 litres on fluid which was managed by retroperitoneoscopic nephrectomy. The patient was a 24-year-old male who presented with a huge abdominal mass, anorexia and weight loss. Laparoscopic surgery for such a large kidney has not been previously reported. We discuss salient features of the procedure and elaborate on the modifications required in the case of significantly enlarged kidneys.
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13/237. 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.
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14/237. Transitional cell papilloma of ureter in young boy.

    A case of transitional cell papilloma of the ureter is reported in a seven-year-old boy who had a history of severe flank pain and was found to have hydronephrosis of the left kidney. A brief review of the literature has revealed that transitional cell papilloma of the ureter is extremely rare in children.
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15/237. 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.
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16/237. Ectopic hydronephrotic kidney masquerading as an ovarian cyst during pregnancy.

    An ectopic iliopelvic kidney with hydronephrosis causing fetal malpresentation is a rare occurrence. We describe this case for its unusual presentation which was mistaken for an ovarian cyst. The difficulty in diagnosis and the need for a high index of suspicion is highlighted.
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17/237. Postural renal transplant obstruction: a case report and review of the literature.

    A 48-year-old woman underwent cadaveric renal transplantation for end-stage renal failure secondary to polycystic kidney disease. Nine months after transplantation, intermittent renal dysfunction and severe graft hydronephrosis developed despite the presence of a ureteric stent. A Tc-99m MAG3 scan performed with the patient standing showed complete transplant obstruction. Rapid tracer clearance with progressive bladder filling was present when the patient was imaged in the supine position. Ureteric obstruction is the most common urologic complication of renal transplantation. However, postural ureteric obstruction has been described only rarely. This case indicates that posture may affect ureteric patency and highlights this potential pitfall in the evaluation of intermittent graft dysfunction by diuretic renography.
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ranking = 0.27334510576217
keywords = kidney, kidney disease
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18/237. Gastrointestinal actinomycosis: an unusual presentation with obstructive uropathy: report of a case and review of the literature.

    A 55-year-old female patient is described who had recurrent retroperitoneal infections without an apparent focus. After a protracted period of illness the infection proved to be caused by actinomycosis. An unusual feature of the inflammatory process consisted of obstruction of the ureters, ultimately resulting in destruction of the left kidney. hydronephrosis resulting from inflammatory fibrosis has not been reported in the literature before.
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19/237. Complications of horseshoe kidney.

    A case of horseshoe kidney complicated by hydronephrosis, renal calculi, urinary infection, and tumor of the renal pelvis is reported. The incidence and etiology of the complications are discussed and the frequency of tumors in horseshoe kidneys described.
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20/237. Rapid loss of renal parenchyma after acute obstruction.

    urinary tract obstruction (UTO) is a frequent cause of renal failure in the pediatric population. We report a patient with type I/I cystinuria, followed prospectively from birth with yearly ultrasonography, who developed acute UTO due to a cystine stone at 10 years of age. In animal models of UTO, acute obstruction produces rapid loss of renal parenchyma secondary to apoptosis of tubular cells. Since we had prospectively obtained serial ultrasonographic measurements of renal growth, we were able to document sudden decrease in kidney size and function following UTO, suggesting that programmed cell death may similarly have caused the rapid irreversible loss of renal parenchyma in our patient. Despite surgical relief of the obstruction, kidney size decreased for at least 3-4 months. We speculate that anti-apoptotic drugs might be considered as a therapeutic strategy to protect ongoing renal parenchyma loss in UTO.
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