scholarly journals 971 A Rare Case of a Reno-colic Fistula Presenting as a Retroperitoneal and Psoas Abscess

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Emmanuel ◽  
P Gravestock ◽  
D Thomas
Keyword(s):  
Rare Case ◽  
Psoas Abscess ◽  
Left Kidney ◽  
Multidisciplinary Care ◽  
Renal Stones ◽  
Good Outcome ◽  
Retrograde Pyelogram ◽  
Descending Colon ◽  
Surgical Teams ◽  
End Stage

Abstract Background Fistulous connections arising between the kidney and colon are rare and develop due to multiple aetiologies. We present a rare case of a reno-colic fistula presenting unusually as a retroperitoneal and psoas abscess managed surgically with a good outcome. Case Report A 49-year-old lady presented with 5-day history of left flank pain and swelling with no significant surgical or medical history. Physical examination revealed a tender left renal angle with raised inflammatory markers (CRP and WCC). Computed tomography (CT) revealed an extensive collection extending from an atrophic left kidney through the retroperitoneum and psoas into the subcutaneous tissues with possible fistulation into the descending colon. This was initially treated with antibiotics and percutaneous drainage of the collection. A reno-colic fistula was confirmed via left retrograde pyelogram. Under the multidisciplinary care of the urology and colorectal general surgical teams she underwent a left nephrectomy, large bowel resection and defunctioning colostomy successfully and was discharged eight days later. Histology later confirmed an extensively scarred atrophic left kidney with multiple renal stones with no preserved glomeruli, focal inflammatory infiltrate and stromal calcification consistent with end stage nephropathy. With the resected 5 cm descending colon showing mucosal and serosal inflammation consistent with site of fistula. Conclusions Reno-colic fistula is rare and presentation with a retroperitoneal and psoas abscess uncommon. We report a rare case of a reno-colic fistula secondary to a chronically infected and obstructed left kidney managed surgically with a good outcome.

scholarly journals Change of Renal Gallium Uptake Correlated with Change of Inflammation Activity in Renal Pathology in Lupus Nephritis Patients

2021 ◽  
Vol 10 (20) ◽  
pp. 4654
Author(s):  
Tsu-Yi Hsieh ◽  
Yi-Ching Lin ◽  
Wei-Ting Hung ◽  
Yi-Ming Chen ◽  
Mei-Chin Wen ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Left Kidney ◽  
Renal Pathology ◽  
Class Iii ◽  
Stage Renal Disease ◽  
End Stage ◽  
Active Inflammation ◽  
Histological Results

Background: Lupus nephritis (LN) often lead to end-stage renal disease in systemic lupus erythematosus patients. This study aimed to investigate the clinical application of renal gallium-67 scans for determining renal histological parameters in LN patients. Methods: Between 2006 and 2018, 237 biopsy-proven and 35 repeat biopsies LN patients who underwent renal gallium scans before or after biopsy were included for analysis. The classification and scoring of LN were assessed according to the International Society of Nephrology/Renal Pathology Society. A delayed 48-h gallium scan was performed and interpreted by semiquantitative methods using left kidney/spine (K/S) ratio. The renal histological results were compared with gallium uptake. Results: Out of 237 participants, 180 (76%) had proliferative LN. Baseline gallium left K/S ratio was significantly higher in class IV LN as compared to class III (median (interquartile range, IQR): 1.16 (1.0–1.3), 0.95 (0.9–1.1), respectively, p < 0.001). Furthermore, changes in gallium uptake between two biopsies were positively correlated with changes activity index (r = 0.357, p = 0.035), endocapillary hypercellularity (r = 0.385, p = 0.032), and neutrophils infiltration (r = 0.390, p = 0.030) in renal pathology. Conclusions: Renal gallium uptake is associated with active inflammation in LN. Changes in renal gallium uptake positively correlated with changes in activity index in renal pathology.

scholarly journals A Rare Case of Vertebral Osteomyelitis and Bilateral Psoas Abscess From an Unknown Source

2020 ◽  
Vol 11 (11) ◽  
pp. 345-347
Author(s):  
Henrik Ghantarchyan ◽  
Simi Philip ◽  
Kathleen Dunn ◽  
Jin S. Suh
Keyword(s):  
Rare Case ◽  
Psoas Abscess ◽  
Vertebral Osteomyelitis ◽  
Unknown Source

Renal medicine

2021 ◽  
pp. 353-382
Author(s):  
Gopesh K. Modi ◽  
Vivekanand Jha
Keyword(s):  
Kidney Disease ◽  
Renal Disease ◽  
Rapidly Progressive Glomerulonephritis ◽  
Kidney Injury ◽  
Renal Stones ◽  
Renal Diseases ◽  
Acute Glomerulonephritis ◽  
Glomerular Diseases ◽  
Stage Renal Disease ◽  
End Stage

Assessing renal function, Urinalysis, Proteinuria, Hematuria, Chyluria, Imaging in renal disease, Kidney biopsy, Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), Diabetic Nephropathy, End Stage Renal Disease and Dialysis, Kidney Transplantation, Glomerular diseases, Acute glomerulonephritis, Urinary schistosomiasis (bilharzia), Infections and Kidney Disease, Rapidly Progressive glomerulonephritis, Tubulointerstitial Disease, Urinary Tract Infection, Vesico-ureteric reflux, Renal Stones, Renal Disease in Pregnancy, Renal Artery Stenosis, Renal Mass, Inherited Renal Diseases

scholarly journals Rare case of a kidney and inferior vena cava abnormalities with extensive lower extremity deep vein thrombosis in a young healthy male

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Muhammad Khalid ◽  
Manisha Nukavarapu ◽  
Rupal Shah ◽  
Timir K. Paul
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Rare Case ◽  
Inferior Vena ◽  
Left Kidney ◽  
Vena Cava ◽  
Healthy Male ◽  
Vein Thrombosis ◽  
Deep Vein

Kidney and inferior vena cava (IVC) abnormalities with extensive deep vein thrombosis (DVT) is a very rare cause of DVT and has a diverse clinical presentation. Computed tomography (CT) angiography is the gold standard for diagnosis and treatment including thrombectomy, thrombolysis and systemic anticoagulation. We present a rare case of active young healthy male admitted with acute onset of right lower extremity pain and swelling who was found to have extensive DVT on doppler ultrasound. CT abdomen showed extensive clot burden involving right common femoral vein extending into internal and external iliac veins associated with IVC hypoplasia and hypoplastic left kidney. Patient underwent urgent thrombectomy, catheter directed thrombolysis and was discharged home in stable condition on oral anticoagulation.

scholarly journals Genitourinary tuberculosis in North America: A rare clinical entity

2015 ◽  
Vol 9 (7-8) ◽  
pp. 484 ◽  
Author(s):  
Michael W Sourial ◽  
Fadi Brimo ◽  
Ruth Horn ◽  
Sero Andonian
Keyword(s):  
North America ◽  
Percutaneous Nephrolithotomy ◽  
Left Kidney ◽  
Granulomatous Inflammation ◽  
Renal Stones ◽  
High Index ◽  
Canadian Woman ◽  
Radiologic Findings ◽  
First Case ◽  
High Index Of Suspicion

Introduction: Although tuberculosis (TB) is the most common cause of mortality from infectious diseases worldwide, genitourinary TB in North America is rare. We review 3 cases of genitourinary TB diagnosed within the last 5 years.Cases: The first case is that of a 76-year-old African-Canadian woman who was referred for percutaneous nephrolithotomy of right lower pole renal stones. Although renal TB was suspected, her initial urinary TB culture was negative. On follow-up imaging, she developed bilateral ureteral thickening and ureteroscopic biopsy confirmed necrotizing granulomata. Repeat urine cultures were positive for M. tuberculosis. The second case is a 73-yearold Italian-Canadian woman who was referred for ureteroscopic biopsy of left thickened ureter to rule out urothelial carcinoma. Initial urine TB cultures were negative, despite biopsies confirming granulomatous inflammation. She was closely followed with urine cytologies and TB cultures. Repeat urine culture was positive for M. tuberculosis. Both patients were treated with a course of anti-tuberculous agents and indwelling ureteral stents to relieve ureteral obstruction. The third case is a 70-year-old Cree woman who was referred for percutaneous nephrolithotomy of a left “staghorn stone” in an atrophic left kidney. Thirty years earlier she had been treated for pulmonary TB in addition to ileocystoplasty for a “thimble” bladder. A computed tomography scan showed autonephrectomized left kidney. Her urine TB cultures were negative. She was placed on prophylactic antibiotics for her recurrent bacterial urinary tract infections.Conclusion: Genitourinary TB may present in various subtle ways, and the astute clinician must have a high index of suspicion for this disease in patients with atypical clinical and radiologic findings. In addition, TB urine cultures should be repeated when there is high index of suspicion.

scholarly journals Chryseobacterium spp-associated bacteraemia in a haemodialysis patient: a diagnostic challenge

2019 ◽  
Vol 12 (11) ◽  
pp. e232000
Author(s):  
Muhammad Junaid Ahsan ◽  
Soban Ahmad ◽  
Azka Latif ◽  
Joseph Thilumala Reddy
Keyword(s):  
End Stage Renal Disease ◽  
Rare Case ◽  
Haemodialysis Patient ◽  
Water Systems ◽  
Hospital Environment ◽  
Human Pathogen ◽  
Diagnostic Challenge ◽  
Negative Bacillus ◽  
Stage Renal Disease ◽  
End Stage

Chryseobacterium species are Gram-negative bacillus widely distributed in nature. It is a rare human pathogen that has been isolated from water systems and humid surfaces of the hospital environment. We report a rare case of Chryseobacterium bacteremia in an end-stage renal disease nursing home resident, that was diagnosed using multiplex PCR and was successfully treated with intravenous piperacillin–tazobactam combination.

A Rare Case of Famotidine-Induced Delirium in a Peritoneal Dialysis Patient

2017 ◽  
Vol 37 (1) ◽  
pp. 118-120 ◽  
Author(s):  
Gary C.W. Chan ◽  
K.M. Lee ◽  
Lorraine P.Y. Kwan ◽  
Maggie M.Y. Mok ◽  
Maggie K.M. Ma ◽  
...  
Keyword(s):  
Dialysis Patient ◽  
Rare Case ◽  
Dosage Adjustment ◽  
Peritoneal Dialysis Patient ◽  
Esophageal Reflux ◽  
Pharmacokinetic Properties ◽  
Neuropsychiatric Manifestations ◽  
Acute Confusion ◽  
Low Incidence ◽  
End Stage

H2 receptor antagonists are commonly employed to manage gastro-esophageal reflux and peptic ulcer diseases with a very low incidence of side effects. Herein, we report an extremely rare incidence of famotidine-induced acute confusion in a patient with end-stage renal failure. We also discuss the pharmacokinetic properties of famotidine and its interplay with compromised renal function to result in neuropsychiatric manifestations, highlighting the importance of dosage adjustment in individuals with renal insufficiency.

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