Asymptomatic emphysematous pyelitis—a rare clinical entity

2021 ◽  
Vol 14 (1) ◽  
pp. e235421
Author(s):  
Hannah Thorman ◽  
Nikita R Bhatt ◽  
Sona Kapoor ◽  
Azad Hawizy
Keyword(s):  
Renal Function ◽  
Percutaneous Nephrolithotomy ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Distal Ureter ◽  
Asymptomatic Woman ◽  
Significant Volume ◽  
Staghorn Calculus ◽  
The Right ◽  
Collecting System

A 62-year-old asymptomatic woman with diabetes was referred to the urology department from nephrology due to deterioration in renal function with accompanied right-sided hydronephrosis on ultrasound. CT imaging subsequently revealed a right-sided staghorn calculus and a significant volume of gas in the right collecting system from the kidney to the distal ureter, in keeping with emphysematous pyelitis. She was admitted and managed with antibiotics and insertion of right nephrostomy in the first instance, followed by percutaneous nephrolithotomy to definitively manage the stone. The patient remained asymptomatic throughout the process.

scholarly journals Supraglottic Laryngeal Paraganglioma: A Rare Clinical Entity managed by Lateral Pharyngotomy Approach

2012 ◽  
Vol 2 (2) ◽  
pp. 69-73
Author(s):  
Sudhir M Naik
Keyword(s):  
Meta Analysis ◽  
Clinical Entity ◽  
Biological Behavior ◽  
Superior Thyroid Artery ◽  
Partial Laryngectomy ◽  
Rare Clinical Entity ◽  
Lateral Pharyngotomy ◽  
Superselective Embolization ◽  
Submucosal Mass ◽  
The Right

ABSTRACT Background/objectives Laryngeal paragangliomas are benign slow growing tumors with symptoms resembling squamous cell carcinoma. Hoarseness or dysphasia is the commonest presenting symptom and usually it presents as a submucosal mass on laryngoscopy. A total of 90% of these tumors occur in the supraglottic larynx and the rest in the glottis and the subglottic region. Functional activity is seen in a few (2.9%), none are associated with paraneoplastic syndromes. Setting Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru. Case report A 35-year-old male presented to us with hoarseness of voice since 4 months duration. Contrast arteriography demonstrated that the left superior thyroid artery supplied greater than 80% of the blood supply to the laryngeal mass. Superselective embolization was done from the right femoral under local anesthesia and sedation which was uneventful. Intervention The tumor was excised from lateral pharyngotomy approach with an elective tracheostomy. Microscopy suggested it to be paraganglioma and immunohistochemistry confirmed it. Conclusion Complete surgical resection or partial laryngectomy with meticulous dissection of surrounding tissues and preservation of neurovascular structures give an excellent prognosis as far as oncological clearance is concerned. Malignant paragangliomas of the larynx are rare and a major meta-analysis is necessary to provide a true biological behavior of this tumor. How to cite this article Naik SM. Supraglottic Laryngeal Paraganglioma: A Rare Clinical Entity managed by Lateral Pharyngotomy Approach. Int J Phonosurg Laryngol 2012;2(2): 69-73.

scholarly journals Lumbar plexopathy as a complication of percutaneous nephrolithotomy in a horseshoe kidney

2015 ◽  
Vol 9 (1-2) ◽  
pp. 78 ◽  
Author(s):  
Andrea Gail Lantz ◽  
R. John D'A Honey
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Psoas Muscle ◽  
Horseshoe Kidney ◽  
Vascular Supply ◽  
Stone Disease ◽  
Laparoscopic Pyelolithotomy ◽  
Staghorn Calculus ◽  
Leg Weakness ◽  
Independent Ambulation ◽  
Collecting System

Treatment of nephrolithiasis in horseshoe kidneys can be challenging due to anomalies in renal position, collecting system anatomy and vascular supply. We report on a patient who was referred after a failed percutaneous nephrolithotomy for a left moiety staghorn calculus in a horseshoe kidney. Two punctures had been performed involving upper and middle posterior calyces. Both were very medially placed and inadvertently traversed the psoas muscle, resulting in lumbar plexopathy with permanent deficit. This complication presented postoperatively with left leg weakness, paresthesia, and pain which impaired independent ambulation. The patient went on to be successfully treated for her stone disease with robotic-assisted laparoscopic pyelolithotomy.

scholarly journals Primary Lymphangioma of the Tonsil: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Dimitrios G. Balatsouras ◽  
Alexandros Fassolis ◽  
George Koukoutsis ◽  
Panayotis Ganelis ◽  
Antonis Kaberos
Keyword(s):  
Case Report ◽  
Histological Examination ◽  
Clinical Examination ◽  
Lymphatic System ◽  
White Male ◽  
Clinical Entity ◽  
Benign Tumors ◽  
Rare Clinical Entity ◽  
Rare Occurrence ◽  
The Right

Benign tumors of the tonsils occur infrequently. Lymphangiomas are rare congenital tumors of the lymphatic system, and tonsillar lymphangioma is an extremely rare occurrence. Its pathogenesis is uncertain, but history, clinical examination, and histological examination should establish the diagnosis. We present a 17-year-old white male with lymphangioma of the right tonsil. The tonsils were excised and biopsy confirmed the diagnosis. Tonsillar lymphangioma is a rare clinical entity, which should be known to the otolaryngologist, in order to diagnose and treat it appropriately and avoid confusion with tonsillar malignancies.

Spontaneous Cholecystocutaneous Fistula: A rare clinical Entity

2019 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Amit Gupta ◽  
Manoj Joshua ◽  
Navin Kumar ◽  
Udit Chauhan ◽  
Sweety Gupta
Keyword(s):  
Gall Bladder ◽  
Histopathological Examination ◽  
Open Cholecystectomy ◽  
Fistulous Tract ◽  
Gall Stone ◽  
Stone Disease ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
The Right ◽  
Operative Recovery

Introduction: Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bladder stone disease infrequently seen in surgical practice due to early diagnosis of gall stone disease with imaging and appropriate and prompt antibiotic and surgical treatment. Case report: We report our experience with a 40-year-old woman who presented with a yellowish discharge from the umbilicus. Abdominal examination revealed a sinus opening at the umbilicus with the yellowish discharge and a vague mass in the right hypochondrium. CT fistulogram showed tract extending form the umbilicus to the gall bladder. Open cholecystectomy with excision of the fistulous tract was carried out. Histopathological examination showed chronic inflammation of the gall bladder with the fistulous tract lined by inflammatory granulation tissue. Post-operative recovery was normal and uneventful. The patient was normal in follow-up. Cholecystocutaneous fistula is a rare clinical entity. The diagnosis is established with CT and MRCP. Surgery remains the mainstay of treatment.

scholarly journals Pain in the right hypochondrium: hepatic epithelioid hemandioendothelioma, a rare clinical entity

2019 ◽  
Vol 103 (805) ◽  
pp. 156-158
Author(s):  
Alba López-Matarín ◽  
◽  
João Miguel Madeira Martins ◽  
Antonio Rizo-Barrios ◽  
Fernando Leiva-Cepas ◽  
...  
Keyword(s):  
Clinical Entity ◽  
Rare Clinical Entity ◽  
The Right

scholarly journals Percutaneous Nephrolithotomy and Horseshoe Kidneys

2020 ◽  
Vol 3 (2) ◽  
pp. 343-346
Author(s):  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parash Mani Shrestha ◽  
Biswa Raj Joshi
Keyword(s):  
Retrospective Study ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Ureteropelvic Junction Obstruction ◽  
Horseshoe Kidney ◽  
Standard Technique ◽  
Stone Clearance ◽  
Percutaneous Access ◽  
Staghorn Calculus ◽  
Collecting System

Introduction: The most common fusion anomaly, horseshoe kidney, is associated with vascular anomalies, malrotation, anterior displacement of the collecting system, superior insertion of ureter into the pelvis, and a higher rate of ureteropelvic junction obstruction; thus increasing the chances of nephrolithiasis. We present our experience with percutaneous nephrolithotomy in this anomaly.Materials and Methods: A retrospective study of all the percutaneous nephrolithotomy performed by standard technique within four years at Bir Hospital was made. A comparison was made with similar cases with the anatomically normal location of the kidney. Intraoperative variables were recorded and postoperative stonefree status and complications were evaluated.Results: Six hundred and twenty-seven patients out of 691 who had undergone percutaneous nephrolithotomy in this period were included. Patients with nephrolithiasis in horseshoe kidney were younger, the incidence of multiple stones was more; without full staghorn calculus and occupying fewer calyces. Upper pole access was easier, a stone clearance of 85.42 % was achieved with no major complications in the horseshoe kidney.Conclusions: Percutaneous access and nephrolithotomy are safe in horseshoe kidney with a good stone clearance rate.

scholarly journals 509 The importance of transesophageal echocardiography in the therapeutic approach of a patient with Hakim-Adams syndrome and right atrial mass

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R S Miftode ◽  
D Crisu ◽  
A O Petris
Keyword(s):  
Pulmonary Embolism ◽  
Infective Endocarditis ◽  
Transesophageal Echocardiography ◽  
Tricuspid Valve ◽  
Right Atrium ◽  
Therapeutic Approach ◽  
Clinical Entity ◽  
Right Atrial ◽  
Rare Clinical Entity ◽  
The Right

Abstract Hakim-Adams Syndrome (HAS) or symptomatic normotensive hydrocephalus is a rare clinical entity (prevalence of 1:25 000 in the general population), characterized by the presence of triad: progressive dementia, ataxia (Parkinson-like) and urinary incontinence. The only efficient therapy for HAS is the implantation of ventriculo-atrial or ventriculo-peritoneal shunts, in order to drain the excess cerebrospinal fluid (CSF). However, long-term maintenance of these devices may predispose to severe complications (e.g. infection, thrombosis). We report the case of a 38 years old patient who suffered a head trauma with subarachnoid hemorrhage and subsequent hydrocephalus, for which a shunt between left lateral cerebral ventricle and right atrium of the heart has been placed. The patient presented progressive resting dyspnea, chest pain and intermittent fever. The initial transthoracic echocardiography revealed a highly mobile mass in the right atrium, without being able to specify the exact place of insertion. In addition, severe pulmonary hypertension and major tricuspid regurgitation were observed. The computed tomography also revealed bilateral pulmonary embolism with areas of pulmonary infarction. The clinical features and echocardiography aspects suggested a possible infective endocarditis of tricuspid valve, therefore a transesophageal echocardiography was necessary. This exploration revealed the presence of a ∼ 40 mm pangliform mass originating from the inter-atrial septum, near the superior vena cava opening in the right atrium, without any link with the tricuspid valve. Basically it was a thrombus, an endoluminal molding of the shunt used to drain CSF. Given the coexistence of pulmonary embolism and the intra-cavitary mass with high emboligenic potential, the heart team in collaboration with neurosurgeons decided to administer heparin, with good clinical and biological evolution. The association between Hakim-Adams syndrome and pulmonary embolism secondary to intra-shunt thrombosis is a very rare clinical entity. The case particularity is also determined by the initial suspicion of infective endocarditis, a diagnosis infirmed only through transesophageal echocardiography. This also guided the further therapeutic approach, considering that anticoagulants are a first-line choice in pulmonary embolism, but are not recommended in endocarditis.

DMSA-scintigraphy in paediatrics: Is the evaluation of the geometric mean necessary for the calculation of the differential renal function?

2001 ◽  
Vol 40 (04) ◽  
pp. 107-110 ◽  
Author(s):  
B. Roßmüller ◽  
S. Alalp ◽  
S. Fischer ◽  
S. Dresel ◽  
K. Hahn ◽  
...  
Keyword(s):  
Renal Function ◽  
Geometric Mean ◽  
Region Of Interest ◽  
Posterior View ◽  
Renal Abnormality ◽  
Anterior View ◽  
Differential Renal Function ◽  
The Mean ◽  
The Right ◽  
To Receive

SummaryFor assessment of differential renal function (PF) by means of static renal scintigraphy with Tc-99m-dimer-captosuccinic acid (DMSA) the calculation of the geometric mean of counts from the anterior and posterior view is recommended. Aim of this retrospective study was to find out, if the anterior view is necessary to receive an accurate differential renal function by calculating the geometric mean compared to calculating PF using the counts of the posterior view only. Methods: 164 DMSA-scans of 151 children (86 f, 65 m) aged 16 d to 16 a (4.7 ± 3.9 a) were reviewed. The scans were performed using a dual head gamma camera (Picker Prism 2000 XP, low energy ultra high resolution collimator, matrix 256 x 256,300 kcts/view, Zoom: 1.6-2.0). Background corrected values from both kidneys anterior and posterior were obtained. Using region of interest technique PF was calculated using the counts of the dorsal view and compared with the calculated geometric mean [SQR(Ctsdors x Ctsventr]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p<0.01). The mean difference between the PFgeom and the PFdors was 1.5 ± 1.4%. A difference > 5% (5.0-9.5%) was obtained in only 6/164 scans (3.7%). Three of 6 patients presented with an underestimated PFdors due to dystopic kidneys on the left side in 2 patients and on the right side in one patient. The other 3 patients with a difference >5% did not show any renal abnormality. Conclusion: The calculation of the PF from the posterior view only will give an underestimated value of the right kidney compared to the calculation of the geometric mean. This effect is not relevant for the calculation of the differntial renal function in orthotopic kidneys, so that in these cases the anterior view is not necesssary. However, geometric mean calculation to obtain reliable values for differential renal function should be applied in cases with an obvious anatomical abnormality.

STUDY OF RADIATION CHARACTERISTICS THE RENAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES

2014 ◽  
pp. 73-77
Author(s):  
Van Chuong Nguyen ◽  
Thi Kim Anh Nguyen
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Disease Duration ◽  
Left Kidney ◽  
Cross Sectional ◽  
The Right

Background: A Research glomerular filtration rate (GFR) of 61 patients with type 2 diabetes mellitus with renal scanning 99mTc-DTPA glomerular filtration rate at the hospital 175. Objective: (1) To study characteristics of imaging of renal function. (2) Understanding the relationship between GFR with blood sugar, HbA1c, blood pressure and albuminuria in patients with type 2 diabetes. Methods: Descriptive, prospective, cross-sectional study. Clinical examination, Clinical tests and 99mTc-DTPA GFR gamma - camera renography for patients. Result: GFR of the study group was 75,4 ± 22,3 ml/phut/1,73m2, the left kidney was 35,0 ± 13,0 is lower than the right kidney and 39,8 ± 11,9; p <0,01. There is no correlation between GFR with blood glucose and HbA1c, the risk of reduced GFR in hypertensive group associated is OR = 6,5 with p<0,01; albuminuria (+) is OR = 4,2 with p <0,01; and disease duration > 10 years is OR = 3,5 with p <0.01. Conclusion: GFR of the left kidneys is lower than the right kidney; correlation decreased GFR associated with hypertension, albuminuria and disease duration. Keywords: GFR, diabetes, albuminuria

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