scholarly journals Heavy Encrustation and Stone Formation on Forgotten Double “J” Ureteral Stent: A Case Repot

2020 ◽  
pp. 1-3
Author(s):  
Muhammad Rafique ◽  
Shoaib Rafique ◽  
Muhammad Rafique
Keyword(s):  
Stone Formation ◽  
Renal Stones ◽  
Postoperative Recovery ◽  
Ureteral Stent ◽  
Patient Counseling ◽  
Related Factors ◽  
Ureteric Stent ◽  
History Of ◽  
Complete Blood Counts

Background: Placement of double “J” ureteral stent for various indications is common in urological surgery. The encrustation and stone formation on forgotten DJ stents can result in significant morbidity and its management remains a challenging task. Case Presentation: A 51 years male presented with history of right flank pain of over 6 months duration. He had undergone right pyelolithotomy for right renal stones 4 years ago at some other hospital. There was no medical record available and the patient did not present himself to the surgeon for follow-up. Clinical examination was unremarkable. His complete blood counts, random blood sugar, renal function tests were normal. Urinalysis revealed many pus cells/hpf. At ultrasonography, there were two renal stone with moderate hydronephrosis and a 2 cm vesical stone. An x-ray KUB, revealed a forgotten ureteric stent with stones at its both ends. The patient underwent cystoscopy and a large stone on ureteric stent was dealt with by litholapaxy. The stone on the proximal end of was managed by percutaneous lithotripsy and stent was removed. The postoperative recovery was uneventful. On stone analysis, it was made of calcium oxalate 30% and ammonium urate 70%. Conclusion: The management of encrusted stents is challenging, and each case has to be dealt with individually depending on stone site and burden, and patient related factors. Endourological management is the preferred option. Adequate patient counseling and proper stent documentation (stent placement, proposed duration and removal of stent) is necessary to minimize stent related complications.

scholarly journals Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Avinash Chennamsetty ◽  
Jason Hafron ◽  
Luke Edwards ◽  
Scott Pew ◽  
Behdod Poushanchi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Incisional Hernia ◽  
Operative Time ◽  
Patient Counseling ◽  
Incisional Hernias ◽  
Prostate Weight ◽  
History Of ◽  
Robotic Assisted Radical Prostatectomy

Introduction.To explore the long term incidence and predictors of incisional hernia in patients that had RARP.Methods.All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair.Results.Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams;P=0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480);P=0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias.Conclusion.Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

scholarly journals Rapunzel syndrome causing partial gastric outlet obstruction requiring emergency laparotomy

2020 ◽  
Vol 13 (1) ◽  
pp. e232904
Author(s):  
Robert Lyons ◽  
Granit Ismaili ◽  
Michael Devine ◽  
Haroon Malik
Keyword(s):  
Ct Scan ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Rapunzel Syndrome ◽  
History Of

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

High Incidence of Renal Stones in Severely Disabled Children with Epilepsy Treated with Topiramate

2019 ◽  
Vol 50 (03) ◽  
pp. 160-163 ◽  
Author(s):  
Nobutsune Ishikawa ◽  
Hiroo Tani ◽  
Yoshiyuki Kobayashi ◽  
Akira Kato ◽  
Masao Kobayashi
Keyword(s):  
Medical Records ◽  
Renal Stone ◽  
Stone Formation ◽  
Renal Stones ◽  
Treated Group ◽  
Urinary Stones ◽  
Disabled Children ◽  
High Incidence ◽  
Diuretic Drugs ◽  
History Of

Purpose This study was aimed to assess the accurate incidence of renal stones in severely disabled children treated with topiramate (TPM). Method We reviewed the medical records of severely disabled children with epilepsy under 15 years old who underwent radiological examinations to investigate urinary stones. The study enrolled 26 patients who were divided into two groups. One group had been treated with TPM for at least 1 year and the other had not been treated with TPM, zonisamide, acetazolamide, or other diuretic drugs. We collected parameters from the medical records and compared the groups. Results All participants were evaluated radiologically, with computed tomography (CT) in two patients, ultrasonography in 22 patients, and both in two. No patient had any morphological abnormality of the kidneys and history of urinary tract infection. There were no significant differences in sex, age, body weight, or feeding manner between the groups, while the incidence of renal stones or calcifications was significantly higher in the TPM-treated group (60 vs. 0%; p = 0.00241). Conclusion There is a high incidence of renal stone formation in severely disabled children treated with TPM.

scholarly journals Gastric schwannoma: a case report and literature review

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095782
Author(s):  
Changsheng Pu ◽  
Keming Zhang
Keyword(s):  
Wedge Resection ◽  
Postoperative Recovery ◽  
Postoperative Treatment ◽  
Laparoscopic Wedge Resection ◽  
Case Presentation ◽  
Gastric Tumors ◽  
Gastric Schwannoma ◽  
History Of ◽  
Upper Abdominal

Background Gastric schwannoma is a rarely seen gastric tumor accounting for only 0.2% of all gastric tumors. It is difficult to distinguish a gastric schwannoma from other gastric tumors preoperatively. Case presentation: A 30-year-old man with no significant medical history or physical examination findings presented with a 1-month history of right upper abdominal discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor, but the postoperative pathologic and immunohistochemical examinations confirmed a gastric schwannoma. The patient underwent laparoscopic wedge resection of the stomach without additional postoperative treatment, and his postoperative recovery was uneventful. No recurrence or metastasis was found at the 2-year follow-up examination. Conclusion Although gastric schwannomas are usually not malignant, they are difficult to distinguish from other malignant stromal tumors preoperatively. Surgical resection should be recommended when a schwannoma is malignant or considered to be at risk of becoming malignant.

scholarly journals Rapunzel syndrome resulting in gastric perforation

2016 ◽  
Vol 98 (1) ◽  
pp. e6-e7 ◽  
Author(s):  
JS Parakh ◽  
A McAvoy ◽  
DJ Corless
Keyword(s):  
Gastric Perforation ◽  
Postoperative Recovery ◽  
Patch Repair ◽  
Free Fluid ◽  
Proximal Jejunum ◽  
Rapunzel Syndrome ◽  
Omental Patch ◽  
History Of ◽  
Entire Stomach

We report the case of an 18-year-old female patient with no past medical history who presented to the emergency department with acute abdominal pain and vomiting on the background of a long history of ingesting hair (trichophagia). Computed tomography revealed pneumoperitoneum and free fluid in keeping with visceral perforation. In addition, a large hair bolus was seen extending in contiguity from the stomach to the jejunum. A laparotomy was performed, revealing an anterior gastric perforation secondary to a 120cm long trichobezoar, which had formed a cast of the entire stomach, duodenum and proximal jejunum. The bezoar was removed and an omental patch repair to the anterior ulcer was performed. The patient made an excellent postoperative recovery and was discharged home with psychiatric follow-up review.

scholarly journals Retrograde ureteric stent insertion from percutaneous suprapubic access to the bladder in renal transplant recipients with ureteric stenosis: a novel minimally invasive technique

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jian-Hui Wu ◽  
Chun-Bai Mo ◽  
Li Dong-Zhai ◽  
Fei Luo ◽  
Qing-Tong Ma ◽  
...  
Keyword(s):  
Case Series ◽  
Complete Recovery ◽  
Percutaneous Nephrostomy ◽  
Ureteral Stent ◽  
Invasive Technique ◽  
Stent Insertion ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Ureteric Stent

Abstract Background Ureteric stricture is a common and salvaging complications after renal transplantation. Two treatment methods are usually used, retrograde ureteral stent placement and percutaneous nephrostomy. The former has a higher failure rate, the latter has a great risk. Therefore, a safe and reliable treatment is needed. Case presentation A technique of retrograde insertion of ureteral stent was established, which was applicable in three transplant recipients with post-transplant ureteral stenosis, and the data was retrospectively recorded. The patients are 2 men and 1 woman, ages 44, 27 and 32 years. These patients underwent a total of five times of retrograde insertion of ureteral stent between 2018 and 2019. None of these patients had any postoperative complication, but all patients had complete recovery from oliguric status within two weeks. Conclusions The retrograde ureteric stent insertion by percutaneous suprapubic access to the bladder (RUS-PSAB) was demonstrated feasibility and safety in a case series with short-term follow-up. However, larger prospective studies are needed.

scholarly journals Family history and risk of kidney stones.

1997 ◽  
Vol 8 (10) ◽  
pp. 1568-1573
Author(s):  
G C Curhan ◽  
W C Willett ◽  
E B Rimm ◽  
M J Stampfer
Keyword(s):  
Family History ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Dietary Calcium ◽  
Dietary Calcium Intake ◽  
History Of ◽  
Kidney Stone Formation ◽  
Risk Of Stone Formation

Kidney stones develop more frequently in individuals with a family history of kidney stones than in those without a family history; however, little information is available regarding whether the increased risk is attributable to genetic factors, environmental exposures, or some combination. In this report, the relation between family history and risk of kidney stone formation was studied in a cohort of 37,999 male participants in the Health Professionals Follow-up Study. Information on family history, kidney stone formation, and other exposures of interest, including dietary intake, was obtained by mailed questionnaires. A family history of kidney stones was much more common in men with a personal history of stones at baseline in 1986 than in those without a history of stones (age-adjusted prevalence odds ratio, 3.16; 95% confidence interval [CI], 2.90 to 3.45). During 8 yr of follow-up, 795 incident cases of stones were documented. After adjusting for a variety of risk factors, the relative risk of incident stone formation in men with a positive family history, compared with those without, was 2.57 (95% CI, 2.19 to 3.02). Family history did not modify the inverse association between dietary calcium intake and the risk of stone formation. These results suggest that a family history of kidney stones substantially increases the risk of stone formation. In addition, these data suggest that dietary calcium restriction may increase the risk of stone formation, even among individuals with a family history of kidney stones.

Temporal Trends of Dietary Risk Factors after a Diagnosis of Kidney Stones

2021 ◽  
pp. CJN.09200721
Author(s):  
Pietro Manuel Ferraro ◽  
Tamara Cunha ◽  
Eric Taylor ◽  
Gary Curhan
Keyword(s):  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Dietary Factors ◽  
Dash Score ◽  
Sweetened Beverages ◽  
Stone Formers ◽  
Supplemental Calcium ◽  
History Of

Diet is an important contributor to kidney stone formation, but there are limited data regarding long-term changes in dietary factors after a diagnosis of a kidney stone. We analyzed data from three longitudinal cohorts, the Health Professionals Follow-Up Study and the Nurses' Health Studies I and II, comparing changes in dietary factors in participants with and without a history of kidney stones during follow-up. The total daily intake of dietary calcium, supplemental calcium, animal protein, caffeine, fructose, potassium, sodium, oxalate, phytate, vitamin D, vitamin C, sugar-sweetened beverages, fluids, NEAP and DASH score were assessed by repeat FFQs and computed as absolute differences; a difference-in-differences (DID) approach was used to account for general temporal changes using data from participants without a history of kidney stones from the same calendar period. 184,398 participants with no history of kidney stones were included, 7,095 of whom became confirmed stone formers. Several intakes changed significantly over time in stone formers compared with non-formers, with some showing a relative increase up to 8 years later, including caffeine (DID 8.8 mg/day, 95% CI 3.4, 14.1), potassium (23.4 mg/day, 95% CI 4.6, 42.3), phytate (12.1 mg/day, 95% CI 2.5, 21.7), sodium (43.1 mg/day, 95% CI 19.8, 66.5) and fluid intake (47.1 mL/day, 95% CI 22.7, 71.5). Other dietary factors showed a significant decrease, such as oxalate (−7.3 mg/day, 95% CI −11.4, −3.2), vitamin C (−34.2 mg/day, 95% CI −48.8, −19.6), and vitamin D (−18.0 IU/day, 95% CI −27.9, −8.0). A significant reduction in sugar-sweetened beverages of −0.5 (95% CI −0.8, −0.3) and −1.4 (95% CI −1.8, −1.0) servings/week and supplemental calcium −105.1 (95% CI −135.4, −74.7) and −69.4 (95% CI −95.4, −43.4) mg/day for NHS I and NHS II, respectively intake was observed in women. Animal protein, dietary calcium, fructose intake, DASH score and NEAP did not change significantly over time. After the first episode of a kidney stone, mild and inconsistent changes were observed concerning dietary factors associated with kidney stone formation.

scholarly journals Identification of patients who will not achieve seizure remission within 5 years on AEDs

Neurology ◽  
2018 ◽  
Vol 91 (22) ◽  
pp. e2035-e2044 ◽  
Author(s):  
David M. Hughes ◽  
Laura J. Bonnett ◽  
Gabriela Czanner ◽  
Arnošt Komárek ◽  
Anthony G. Marson ◽  
...  
Keyword(s):  
External Validation ◽  
Clinical Information ◽  
Patient Counseling ◽  
Degree Relative ◽  
History Of ◽  
Similar Accuracy ◽  
Patient’S History ◽  
Patients With Epilepsy ◽  
Baseline Covariates

ObjectiveTo identify people with epilepsy who will not achieve a 12-month seizure remission within 5 years of starting treatment.MethodsThe Standard and New Antiepileptic Drug (SANAD) study is the largest prospective study in patients with epilepsy to date. We applied a recently developed multivariable approach to the SANAD dataset that takes into account not only baseline covariates describing a patient's history before diagnosis but also follow-up data as predictor variables.ResultsChanges in number of seizures and treatment history were the most informative time-dependent predictors and were associated with history of neurologic insult, epilepsy type, age at start of treatment, sex, and having a first-degree relative with epilepsy. Our model classified 95% of patients. Of those classified, 95% of patients observed not to achieve remission at 5 years were correctly classified (95% confidence interval [CI] 89.5%–100%), with 51% identified by 3 years and 90% within 4 years of follow-up. Ninety-seven percent (95% CI 93.3%–98.8%) of patients observed to achieve a remission within 5 years were correctly classified. Of those predicted not to achieve remission, 76% (95% CI 58.5%–88.2%) truly did not achieve remission (positive predictive value). The predictive model achieved similar accuracy levels via external validation in 2 independent United Kingdom–based datasets.ConclusionOur approach generates up-to-date predictions of the patient's risk of not achieving seizure remission whenever new clinical information becomes available that could influence patient counseling and management decisions.

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