scholarly journals Fungal Bezoar: A Rare Cause of Ureteral Obstruction

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Nabil Zeineddine ◽  
Wissam Mansour ◽  
Sandy El Bitar ◽  
Marco Campitelli ◽  
Neville Mobarakai
Keyword(s):  
Renal Pelvis ◽  
Urine Culture ◽  
Kidney Injury ◽  
Horseshoe Kidney ◽  
Fungus Ball ◽  
Emphysematous Pyelonephritis ◽  
Laboratory Findings ◽  
Oral Fluconazole ◽  
The Right ◽  
Clear Majority

A 52-year-old male, with diabetes mellitus and alcoholic liver disease, presented to the Emergency Room for right flank pain of 3 days’ duration, associated with dysuria. Physical examination revealed right flank tenderness with fever and hypotension; laboratory findings showed acute kidney injury and large blood and leucocytes in the urine. A CT abdomen and pelvis showed hydronephrosis of the right collecting system of a horseshoe kidney with air and hyperdense debris in the renal pelvis. Patient was treated for multisensitive Proteus mirabilis emphysematous pyelonephritis, and a right nephrostomy tube was inserted. Symptoms recurred in 4 weeks, and repeated urine culture grew Candida albicans and CT scan showed same high density material within the right moiety of the horseshoe kidney. Patient underwent ureteroscopy, and a white fluffy material was aspirated from the right renal pelvis. Pathology of the aspirate confirmed the presence of fungal balls. Patient was given 2 weeks of oral fluconazole. Fungal pyelonephritis is unusual and difficult to treat. Candida species is responsible for the clear majority of the cases. A fungus ball should be managed with surgical and medical therapy. This patient had an endoscopic procedure to remove the fungus ball and received fluconazole. His symptoms resolved and urine culture was done before termination of the treatment was negative.

Upper Urinary Tract Adenocarcinoma Arising in Tubular Adenoma—A Rare Entity: Report of 2 Cases and Review of Literature

2019 ◽  
Vol 28 (3) ◽  
pp. 310-315
Author(s):  
Kaniyappan Nambiyar ◽  
Tushar Pandey ◽  
Debajyoti Chatterjee ◽  
Uma N. Saikia ◽  
Ravimohan S. Mavuduru
Keyword(s):  
Urinary Tract ◽  
Renal Pelvis ◽  
English Literature ◽  
Horseshoe Kidney ◽  
Renal Calculi ◽  
Upper Urinary Tract ◽  
Tubular Adenoma ◽  
Review Of Literature ◽  
First Case ◽  
The Right

Tubular adenoma of the urinary tract is a recently recognized entity, and there is a paucity of clinicopathological information. We describe 2 rare cases of adenocarcinoma of upper urinary tract arising in the background of tubular adenoma with high-grade dysplasia. The first case was an extremely uncommon combination of multifocal tubular adenomas involving ureter and renal pelvis and adenocarcinoma of kidney in a patient with renal calculi. The second case was of adenocarcinoma of kidney arising from tubular adenoma of renal pelvis in the right moiety of horseshoe kidney. There was no microsatellite instability. These findings indicate, probably, an adenoma-carcinoma pathway is also followed in the urinary tract similar to the gastrointestinal tract. To the best of our knowledge, no such observations are reported in the English literature previously.

Acute Kidney Injury Due to Emphysematous Pyelonephritis on a Horseshoe Kidney

Renal Failure ◽  
2011 ◽  
Vol 33 (7) ◽  
pp. 730-731 ◽  
Author(s):  
P. Sriramnaveen ◽  
A. Sridhar ◽  
Y. Sandeep ◽  
C. Krishna Kishore ◽  
Y. Manjusha ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Horseshoe Kidney ◽  
Emphysematous Pyelonephritis

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

scholarly journals Laparoscopic transposition for crossing vessels (vascular hitch) in pure extrinsic pelvic-ureteric junction obstruction: a successful case report of a 2-year-old infant with horseshoe kidney

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Satoshi Ieiri ◽  
Kouji Nagata
Keyword(s):  
Laparoscopic Surgery ◽  
Left Kidney ◽  
Horseshoe Kidney ◽  
Renal Scintigraphy ◽  
Multicystic Dysplastic Kidney ◽  
Extrinsic Compression ◽  
Dysplastic Kidney ◽  
Renal Vessels ◽  
The Right ◽  
Crossing Vessels

Abstract Background Pediatric hydronephrosis induced by pelvic-ureteric junction obstruction (PUJO) is treated by dismembered pyeloplasty (DP) via open and laparoscopic surgery. The etiology of PUJO involves both intrinsic stenosis and extrinsic compression of crossing vessels (CVs). PUJO owing to CVs is also treated by DP, as there is no consensus concerning this vascular condition. We encountered a 2-year-old infant with pure extrinsic PUJO combined with horseshoe kidney who successfully underwent laparoscopic transposition for CVs (vascular hitch). Case presentation A 2-year-old boy was prenatally diagnosed with left multicystic dysplastic kidney (MDCK) and right hydronephrosis and received a definitive diagnosis after birth. At 6 months old, renal scintigraphy revealed a non-functioning pattern in the left kidney and an obstructive pattern in the right, showing no response to furosemide loading. The patient also had recurrent urinary tract infection, and his right hydronephrosis gradually worsened. We decided to perform surgery for the right PUJO. Preoperative enhanced computed tomography detected three right renal vessels independently branching from the abdominal aorta. The middle renal vessels were located at the ventral side of the pelvis and coincident with the site of PUJO. These vessels were suspected of being CVs. The patient underwent laparoscopic surgery electively. A 5-mm trocar was inserted at the umbilicus for a 5-mm, 30° rigid scope. Two additional ports were then inserted under laparoscope inspection. The dilated right pelvis and CVs were detected after ascending colon mobilization. To confirm the pathogenesis of PUJO, the CVs were dissected and taped. After taping the CVs, an intraoperative diuretic test was performed using furosemide loading. Peristalsis of the right ureter was recognized, and the extrinsic PUJO owing to the CVs was definitively confirmed. We therefore performed transposition for the CVs (vascular hitch procedure). The CVs were mobilized in the cranial direction and those were wrapped by dilated pelvis. The post-operative course was uneventful. The renal scintigraphy findings improved and showed a favorable response of furosemide loading. Conclusions The laparoscopic vascular hitch procedure is minimally invasive and effective for extrinsic PUJO due to CVs. Anastomotic stricture after Anderson and Hynes DP can be prevented by appropriate patient selection.

Percutaneous Identification and Removal of Fungus Ball from Renal Pelvis

1986 ◽  
Vol 135 (6) ◽  
pp. 1232-1233 ◽  
Author(s):  
Joel Abramowitz ◽  
Jackson E. Fowler ◽  
Krishna Talluri ◽  
Marek Stobnicki ◽  
Patrick McCarthy ◽  
...  
Keyword(s):  
Renal Pelvis ◽  
Fungus Ball

scholarly journals Pure laparoscopic unilateral nephrectomy for a patient with a polycystic horseshoe kidney

2014 ◽  
Vol 8 (11-12) ◽  
pp. 881 ◽  
Author(s):  
Shawn Dason ◽  
Christopher B Allard ◽  
Bobby Shayegan ◽  
Kevin Piercey
Keyword(s):  
Renal Transplantation ◽  
Autosomal Dominant ◽  
Iliac Fossa ◽  
Laparoscopic Approach ◽  
Horseshoe Kidney ◽  
Laparoscopic Nephrectomy ◽  
Polycystic Kidney ◽  
Large Size ◽  
Autosomal Dominant Polycystic Kidney ◽  
The Right

A 45-year-old female patient with autosomal dominant polycystic kidney disease (ADPKD) and a horseshoe kidney underwent right laparoscopic nephrectomy. The indication for nephrectomy was to create space within the right iliac fossa for renal transplantation. The operation proceeded as routine for laparoscopic nephrectomy for ADPKD, but was uniquely challenging due to the large size and extensive vasculature of the polycystic horseshoe kidney. In addition to documenting the feasibility of the pure laparoscopic approach for nephrectomy in patients with ADPKD and horseshoe kidney, this case highlights the abnormal location and vasculature encountered when operating on horseshoe kidneys.

scholarly journals McCune Albright syndrome - association of fibrous dysplasia, café-au-lait skin spots and hyperthyroidism – case report

2016 ◽  
Vol 89 (4) ◽  
pp. 559-564
Author(s):  
Iulian Raus ◽  
Roxana Elena Coroiu
Keyword(s):  
Fibrous Dysplasia ◽  
Insufficiency Fracture ◽  
Endocrine Disorders ◽  
Appendicular Skeleton ◽  
Laboratory Findings ◽  
Mccune Albright Syndrome ◽  
Magnetic Resonance Imaging Mri ◽  
Albright Syndrome ◽  
The Right ◽  
Mccune Albright

McCune–Albright syndrome is a rare sporadic disease characterized by bone fibrous dysplasia, café-au-lait skin spots and a variable association of hyperfunctional endocrine disorders. Fibrous dysplasia (FD), which can involve the craniofacial, axial, and appendicular skeleton, may range from an isolated, asymptomatic monostotic lesion to a severe disabling polyostotic disease involving the entire skeleton. A twenty-five-year old male patient presented to our clinic with recently developed heart palpitations. He had also been feeling pain in the right femur since he was younger, without any trauma history, leading to difficulties of ambulation and limping occasionally. His physical examination revealed café-au-lait spots with irregular borders and right testicular agenesis. Laboratory findings identified hyperthyroidism with hyperparathyroidism. Radiographs of the pelvis revealed multiple lytic lesions of the right femur and magnetic resonance imaging (MRI) characterized these lesions as specific to fibrous dysplasia of the bone, without any insufficiency fracture at this level.The association of café-au-lait skin spots with bone fibrous dysplasia, and hyperthyroidism in this patient suggested the diagnosis of McCune – Albright syndrome.

scholarly journals Renal resistivity index as an aid in the diagnosis of acute kidney injury in bitches with pyometra

2021 ◽  
Vol 15 (3) ◽  
pp. 225-228
Author(s):  
Aline de Sousa Alves ◽  
Fernanda Vieira Henrique ◽  
Sabrina Barros Araújo ◽  
Dayanny de Sousa Alencar ◽  
Higina Moreira Melo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Small Animal ◽  
Kidney Injury ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Resistivity Index ◽  
Gamma Glutamyltransferase ◽  
Early Markers ◽  
The Right

This study aimed to evaluate the renal function of six bitches of various breeds and ages, with open pyometra, attended in the Small Animal Medical Clinic sector of the Veterinary Hospital from Federal University of Campina Grande, through the measurement of laboratory tests: urea and creatinine serum, dosage of the urinary Protein-Creatinine Ratio (PCR), urinary gamma-glutamyltransferase (GGT) and determination of the renal resistivity index (RI). The levels of urea and creatinine were elevated in 16.6% (1/6) of the female dogs; the urinary protein-creatinine ratio was increased in 66.6% (4/6), while the urinary gamma-glutamyltransferase value was elevated in 50% (3/6). The renal resistivity index was increased in the right and left kidneys by 66.6% (4/6) of bitches, with no statistical difference between them. It was concluded that the renal resistivity index was a practical and effective method to assist in the diagnosis of acute kidney injury, along with other early markers, such as PCR and urinary GGT.

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