scholarly journals A rare case of spontaneous parenchymal kidney explosion in a patient with ureteral obstruction caused by a single stone

2020 ◽  
pp. 039156032097588
Author(s):  
Francesco Chiancone ◽  
Clemente Meccariello ◽  
Maria Ferraiuolo ◽  
Giovanna Paola De Marco ◽  
Maurizio Fedelini ◽  
...  
Keyword(s):  
Ureteral Obstruction ◽  
Rare Complication ◽  
Hypovolemic Shock ◽  
Vascular Diseases ◽  
Renal Cysts ◽  
Urinary Stones ◽  
Periarteritis Nodosa ◽  
The Moment ◽  
Renal Rupture ◽  
Collecting System

Introduction: Spontaneous rupture of kidney may involve collecting system or parenchyma. Parenchymal rupture usually occurs in patients with renal cell carcinoma, angiomyolipoma, renal cysts, arteriovenous malformation or vascular diseases such as periarteritis nodosa. Collecting system rupture is usually a rare complication of obstructive urolithiasis. We describe the unusual cases of spontaneous kidney rupture in patients with acute urinary obstruction. Case presentation: The case report describes the left parenchymal kidney explosion related to ipsilateral ureteral obstruction caused by a single ureteral stone. The patient reached our emergency department with acute left flank pain and massive haematuria. At the moment of admission, the patient was in stage III hypovolemic shock and had a lower haematocrit (haemoglobin = 4.9 g/dL). Despite blood transfusions, emergency surgical exploration, extrafascial nephrectomy and intensive support care, the patient died twelve hours after surgery. Conclusions: Parenchymal renal rupture can be a life-threatening emergency. Despite its rarity, in the differential diagnosis of acute abdomen, parenchymal renal rupture should always be considered in patients with abdominal pain and an anamnesis or history of urinary stones, pointing out the need of early diagnosis also in benign urological conditions.

scholarly journals Intraperitoneal hemorrhage after cupping therapy

2018 ◽  
Vol 27 (2) ◽  
pp. 107-109
Author(s):  
Meng-Chuan Lu ◽  
Chih-Jen Yang ◽  
Shih-Hung Tsai ◽  
Chih-Chieh Hung ◽  
Sy-Jou Chen
Keyword(s):  
Rare Complication ◽  
Hypovolemic Shock ◽  
Cupping Therapy ◽  
Tissue Ischemia ◽  
Intraperitoneal Hemorrhage ◽  
Relieve Pain ◽  
History Of ◽  
Enhanced Computed Tomography ◽  
Clinical Conditions ◽  
High Degree

Introduction: Cupping therapy has been widely performed in oriental countries and considered a safety alternative to relieve pain. Here, we report a rare complication from abdominal cupping. Case presentation: A 49-year-old man presented with a 2-day history of left upper quadrant abdominal pain after cupping therapy 3 days earlier. His abdomen was soft but appeared a localized rebounding tenderness. Contrast-enhanced computed tomography of the abdomen showed intraperitoneal hemorrhage originated from the left upper quadrant of the omentum. Discussion: Several mechanisms are proposed for the development of intraperitoneal hemorrhage after cupping therapy, including the tensile stress generated by cupping that facilitates the disruption of omentum vessels, strong negative pressure generated by cupping that suppresses blood supply to the cup-applied sites causing adjacent tissue ischemia, and subsequent vascular extravasation. Treatment for intraperitoneal hemorrhage depends on clinical conditions. Stable patients can be managed conservatively, whereas surgery is reserved for those with continuous bleeding and hypovolemic shock. Conclusion: Cupping therapy complicated with omentum bleeding can present insidiously until peritoneal irritation developed by intraperitoneal hemorrhage. A comprehensive history taking and a high degree of vigilance are crucial to diagnose early patients with this rare complication.

scholarly journals Compartment Syndrome Related to Patient Positioning in the Surgical Treatment of Urolithiasis

2021 ◽  
Author(s):  
Inés Laso-García ◽  
Fernando Arias-Fúnez ◽  
Gemma Duque-Ruiz ◽  
David Díaz-Pérez ◽  
Alberto Artiles-Medina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Percutaneous Nephrolithotomy ◽  
Rare Complication ◽  
Patient Positioning ◽  
Lower Limbs ◽  
Urinary Stones ◽  
Ureteral Stones ◽  
Lithotomy Position ◽  
American Society

The incidence of urolithiasis is progressively increasing worldwide, as is the surgical treatment of urinary stones. The most frequent surgery for urolithiasis is ureterorenoscopy, which is performed in the lithotomy position. This position is also used in the endoscopic approach to bladder stones. Lateral decubitus is rarely used in the treatment of urinary stones. In the case of complex kidney stones, the gold standard treatment is percutaneous nephrolithotomy. This surgery has traditionally been performed in the prone position. However, the use of the supine (Valdivia) position is increasing in recent times. Furthermore, the Galdakao-modified supine Valdivia position has been widely used for percutaneous nephrolithotomy since it was described by Ibarluzea et al. in 2007. Treatment of kidney and ureteral stones simultaneously is allowed in both supine positions. In addition, they allow the removal of encrusted stents and the easy placement of double J stents and, in the case of the Galdakao-modified supine Valdivia position, percutaneous nephrostomies. Compartment syndrome is a rare complication in the lithotomy position, but scarcely described in the supine position. This especially applies to the Galdakao-modified supine Valdivia position, in which the lower limbs are in moderate flexion, with the ipsilateral lower limb in a slightly lower position relative to the other. This complication can lead to skin necrosis, myoglobinuric renal failure, amputation, permanent neuromuscular dysfunction, and even death. Risk factors include Body Mass Index, male gender, obesity, increased muscle mass, peripheral vascular disease (advanced age, hypertension, hyperlipidemia and diabetes mellitus), height, lack of operative experience, significant bleeding during surgery, hypothermia, acidemia, combination general-spinal anesthesia, prolonged surgical time, systemic hypotension, ASA (American Society of Anesthesiologists) class or vasoconstrictor drugs. Therefore, compartment syndrome of the leg is a potentially devastating complication that must be suspected and treated through early decompression of the compartment by four compartment fasciotomy. Preventive measures reduce the incidence of this condition.

scholarly journals A rare complication: Infection in acromegalic renal cysts

2020 ◽  
Vol 8 (12) ◽  
pp. 3551-3552
Author(s):  
Yuki Mori ◽  
Yuki Otsuka ◽  
Yasuhiro Nakano ◽  
Hiroyuki Sakae ◽  
Kou Hasegawa ◽  
...  
Keyword(s):  
Rare Complication ◽  
Renal Cysts

scholarly journals Subacute uterine inversion following an induced abortion in a teenage girl: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Asiphas Owaraganise ◽  
Leevan Tibaijuka ◽  
Joseph Ngonzi
Keyword(s):  
Rare Complication ◽  
Hypovolemic Shock ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Unsafe Abortion ◽  
Axillary Temperature ◽  
Uterine Inversion ◽  
History Of ◽  
Failed Surgery

Abstract Background Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. Case presentation We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. Conclusion Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.

Rare complication after ileal pouch-anal anastomosis: Bilateral ureteral obstruction due to pelvic sepsis and retroperitoneal fibrosis

2012 ◽  
Vol 16 (2) ◽  
pp. 81-83 ◽  
Author(s):  
Leonardo Maciel da Fonseca ◽  
Cristiane de Souza Bechara ◽  
Conrado Leonel Menezes ◽  
Carlos Eduardo Corradi Fonseca ◽  
Rodrigo Gomes da Silva
Keyword(s):  
Ureteral Obstruction ◽  
Ileal Pouch ◽  
Retroperitoneal Fibrosis ◽  
Rare Complication ◽  
Ileal Pouch Anal Anastomosis ◽  
Pelvic Sepsis ◽  
Anal Anastomosis

Periarteritis nodosa with perforation of the colon: a rare complication

1963 ◽  
Vol 8 (5) ◽  
pp. 463-471 ◽  
Author(s):  
William I. Rosenblum ◽  
Gleb N. Budzilovich ◽  
Cyril Solomon
Keyword(s):  
Rare Complication ◽  
Periarteritis Nodosa

scholarly journals Bilateral Ureteral Obstruction in Children after Appendectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
M. Grande ◽  
G. Lisi ◽  
D. Bianchi ◽  
P. Bove ◽  
R. Miano ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Urinary Bladder ◽  
Ureteral Obstruction ◽  
Rare Complication ◽  
Moderate Degree ◽  
Ureteric Obstruction ◽  
Transabdominal Ultrasound ◽  
Bladder Base ◽  
Inflammatory Changes

Acute renal failure due to bilateral ureteral obstruction is a rare complication after appendectomy in children. We report a case of bilateral ureteric obstruction in a 14-year-old boy nine days after surgery for an acute appendicitis. After saline-filling of the urinary bladder, transabdominal ultrasound demonstrated bilateral hydronephrosis of moderate degree. No abscess was found with CT but presence of millimetric stones on both distal ureters was shown, with bilateral calyceal dilatation. Cystoscopy revealed inflammatory changes in the bladder base. Following introduction of bilateral ureteric stents, there was rapid normalisation of urinary output and serum creatinine.

scholarly journals THE ROLE OF POST-TRAUMATIC HYPOTENSIA IN THE TREATMENT OF TRAUMATIC DISEASE

2018 ◽  
Keyword(s):  
Intensive Care ◽  
Hypovolemic Shock ◽  
Postoperative Mortality ◽  
Soft Tissue Injuries ◽  
Abdominal Organs ◽  
Severity Of Injury ◽  
Upper And Lower Extremities ◽  
Post Traumatic ◽  
The Moment ◽  
Time Of Admission

This study is based on the experience of treating 127 victims with a diagnosis of “Polytrauma, shock II-III degree” with soft tissue injuries, fractures of the upper and lower extremities, pelvis, spine, chest, abdominal organs without loss of consciousness, which the team at the scene emergency medical assistance was provided to the ambulance, and in the anesthesiology and resuscitation department of the “AI. Meshchaninov Hospital of Emergency Medicine”. The three groups were formed: 40, 51 and 36 victims with randomization by severity of injury (ISS scale), severity of general condition at the time of admission (APACHE II scale), by duration from the moment of injury to admission to hospital, by structure of injury and on a scale of Glasgow. In each of the periods, a different local protocol of anti-shock intensive care was applied. In all patients, the mean, systolic and diastolic blood pressure was repeatedly measured, and the heart rate was recorded. At the hospital stage during the first 2 hours from the moment of receipt, these parameters were determined with an interval of 5 minutes. At the same time, average values for the entire observation period were used for the calculation - in the hospital and at the prehospital stage. The stroke volume, the minute blood volume, the cardiac index, and the total peripheral vascular resistance were also determined. Hemodynamic parameters were analyzed at various stages of medical care, the number of complications, the length of stay in the intensive care unit and the mortality rate in patients. Based on the results obtained, an intensive care algorithm was formed for a polytrauma with signs of hypovolemic shock, aimed at obtaining the maximum result in the shortest possible time and allowing reduce the number of complications and postoperative mortality.

scholarly journals Modern methods of surgical treatment of staghorn nephrolithiasis

2021 ◽  
Vol 102 (1) ◽  
pp. 60-73
Author(s):  
M E Sitdykova ◽  
E A Viktorov ◽  
A Ju Zubkov
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Treatment Options ◽  
High Tech ◽  
Advantages And Disadvantages ◽  
Effective Removal ◽  
Simultaneous Operations ◽  
Working Age ◽  
The Moment ◽  
Collecting System

Staghorn nephrolithiasis is a form of urolithiasis characterized by kidney stones formation that partially or completely fills the collecting system. Staghorn nephrolithiasis has a malignant course, accompanied by collecting system retention and impaired renal function. This pathology is a common cause of disability, which is particularly importance in the context of its prevalence among people of working age. The review systematizes the currently relevant data on surgery of staghorn nephrolithiasis, presents methods of surgical treatment, defines the selection options within them, their advantages and disadvantages, indications, contraindications and complications. This information can help in making an informed decision and increase the effectiveness of treatment for patients with that disease. At the moment, there is an arsenal of treatment options for staghorn nephrolithiasis, among them minimally invasive high-tech operations are the most advanced and recognized as the methods of choice. The modernization of existing technologies increases their efficiency and safety, but their high cost and the impossibility of using in some cases often make one prefer more traumatic radical interventions. Traditional surgery remains a reliable method of treatment, allowing simultaneous operations and treatment of complex cases of the disease. The possibility of combining existing methods allows for the effective removal of staghorn stones in different groups of patients. Thus, a careful and differentiated approach to the methods of surgical treatment of staghorn nephrolithiasis, their use in combination allows ensuring high efficiency of surgical treatment of this pathology.

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