scholarly journals Nephrectomy in Patient of Chronic Pyelonephritis with Non Functioning Kidney on Left Side: A Case Report

2021 ◽  
pp. 400-404
Author(s):  
Swapna G. Morey ◽  
Ranjana Sharma ◽  
Deepali Ghungrud
Keyword(s):  
Malignant Tumors ◽  
Left Kidney ◽  
Traumatic Injury ◽  
Kidney Injury ◽  
Previous Treatment ◽  
Renal Surgery ◽  
Tramadol Hydrochloride ◽  
Patient Response ◽  
Ablative Surgery ◽  
Enhanced Computed Tomography

Introduction: There are two types of renal surgery i.e. partial nephrectomy and one other is total nephrectomy. Mostly, nephrostomy performs in malignant tumors of the renal. Sometimes it performs in kidney injury due to that no longer function and it may create any obstructive disorder in the renal system. Patient Information: A 45-year-old male patient presented with complaints of pain in the abdomen since 4 months. The patient was advised to ultrasonography abdomen and pelvis. Contrast-enhanced computed tomography (CE-CT) abdomen and pelvis were done. Previous treatment was undergone left-sided PCN for gross hydronephrosis of the left kidney. But after 4 months patient developed abdomen pain which was insidious in onset and progressive in nature. The pain was dull aching, in the left loin region, radiating to the back and intermittent. There are no aggravating or relieving factors associated with it and the patient is now referred to our hospital for further management patient was admitted to the male surgical ward. After the surgery planed left simple nephrectomy. Post-operative medication given, Inj. Revotaz (Piperacillin and tazobactam) 4.45 gm, Inj. Nirmet (Metronidazole) 100 ml, Inj Pantomay (Pantoprazole) 40 mg, Inj. Setron (Ondansetron) 4 mg, Inj tramadex (Tramadol hydrochloride) 100 mg, Inj temfix IV (Paracetamol) 100 ml. Discussion: Nephrectomy is one of the urologists conducting the most common ablative surgery. A non-functional kidney or an irreversibly impaired kidney is the commonest sign for a nephrectomy. Chronic infection, obstruction, calculus disease and serious traumatic injury are other typical indications for nephrectomy. Conclusion: In this case, the patient was on a closed monitor. To accomplish overall the situation during the time of surgery. Over all the patient response was positive for conservative and nursing management and after treatment the patient was discharged without any postoperative complications and satisfaction with full recovery.

scholarly journals Risk of acute kidney injury after contrast-enhanced computed tomography in emergency department

2020 ◽  
pp. 102490792091339
Author(s):  
Seda Dağar ◽  
Emine Emektar ◽  
Hüseyin Uzunosmanoğlu ◽  
Şeref Kerem Çorbacıoğlu ◽  
Özge Öztekin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Contrast Media ◽  
Kidney Injury ◽  
Intravenous Contrast ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Despite its risks associated with renal injury, intravenous contrast media increases diagnostic efficacy and hence the chance of early diagnosis and treatment, which leaves clinicians in a dilemma regarding its use in emergency settings. Objective: The aim of this study was to determine the risk and predictors of contrast-induced acute kidney injury following intravenous contrast media administration for computed tomography in the emergency department. Methods: All patients aged 18 years and older who had a basal creatinine measurement within the last 8 h before contrast-enhanced computed tomography and a second creatinine measurement within 48–72 h after computed tomography scan between 1 January 2015 and 31 December 2017 were included in the study. Characteristics of patients with and without contrast-induced acute kidney injury development were compared. Multivariate regression analysis was used to assess the predictors for contrast-induced acute kidney injury. Results: A total of 631 patients were included in the final statistical analysis. After contrast media administration, contrast-induced acute kidney injury developed in 4.9% ( n = 31) of the patients. When the characteristics of patients are compared according to the development of contrast-induced acute kidney injury, significant differences were detected for age, initial creatinine, initial estimated glomerular filtration rate, and all acute illness severity indicators (hypotension, anemia, hypoalbuminemia, and need for intensive care unit admission). A multivariate logistic regression analysis was performed. The need for intensive care unit admission (odds ratio: 6.413 (95% confidence interval: 1.709–24.074)) and hypotension (odds ratio: 5.575 (95% confidence interval: 1.624–19.133)) were the main factors for contrast-induced acute kidney injury development. Conclusion: Our study results revealed that hypotension, need for intensive care, and advanced age were associated with acute kidney injury in patients receiving contrast media. Therefore, we believe that to perform contrast-enhanced computed tomography in emergency department should not be decided only by checking for renal function tests and that these predictors should be taken into consideration.

A rare case of xanthogranulomatous pyelonephritis in a child with a doubling of the upper urinary tract (clinical case)

2019 ◽  
pp. 79-82 ◽  
Author(s):  
N. B. Kireeva ◽  
D. A. Alyautdinova ◽  
N. Yu. Orlinskaya
Keyword(s):  
Acute Pyelonephritis ◽  
Clinical Case ◽  
Wilms Tumor ◽  
Left Kidney ◽  
Kidney Injury ◽  
Xanthogranulomatous Pyelonephritis ◽  
Lower Segment ◽  
Morphological Examination ◽  
Kidney Tumors ◽  
Single Observation

Xanthogranuomatous pyelonephritis (CP) is an aggressive form of interstitial nephritis, including purulentdestructive and proliferative processes in the kidney to form granulomatous tissue. The difficulty of diagnosis of CP, low illumination of this problem in the literature are the reason for the publication of even a single observation. The exact diagnosis of the disease can be established only with morphological examination and, as a rule, after surgical treatment. The clinical observation of the treatment of the child 15 years xanthogranulomatous pyelonephritis, inpatient Nizhny Novgorod regional children's teaching hospital. A boy M. at the age of 15 years entered the clinic of acute pyelonephritis (fever up to 38–39°С, abdominal pain and left side). From anamnesis it is known that at the age of one year the child was diagnosed with recurrent leukocyturia. Urological examination revealed hydronephrosis of the lower half of the double kidney on the left. At the age of 7 he was operated on (due to negative dynamics), reconstructive surgery was performed – prilohanochnaya pyeloplasty on the lower segment of the double kidney on the left. In the subsequent exacerbations of pyelonephritis was not. 6 years after hepatitis and kidney injury (contusion), there was a significant increase in dilation of the abdominal system of the lower segment of the left kidney with exacerbation of secondary pyelonephritis. According to intravenous urography, MSCT, MRI (performed to exclude Wilms tumor), the absence of the function of the lower segment of the kidney with a sharp increase in its size was determined. After the preoperative examination, the left kidney was examined, in which the signs of xanthogranulomatous pyelonephritis (renal tissue of bright yellow color), lower left heminephroureterectomy were found, the Diagnosis was confirmed by morphological examination. In the postoperative period, a cyst of the lower pole of the kidney was formed, cured by percutaneous drainage, sclerosing under ultrasound control, followed by recovery. Thus, this clinical case demonstrates the complexity of the diagnosis of CP, which often occurs under the mask of a variety of diseases, including acute pyelonephritis and kidney tumors. Reliable diagnosis of xanthogranulomatous pyelonephritis is possible only with the help of histological examination of pathological tissues.

scholarly journals Gigantic kidney tumour presenting with weight gain

2019 ◽  
Vol 6 (11) ◽  
pp. 4181
Author(s):  
Balaji Chandhirasekar ◽  
Sushanto Neogi ◽  
Manu Vats ◽  
Vineet Kumar Pandey
Keyword(s):  
Computed Tomography ◽  
Renal Mass ◽  
Left Kidney ◽  
Papillary Renal Cell Carcinoma ◽  
En Bloc ◽  
Kidney Tumour ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Open Nephrectomy ◽  
Contrast Enhanced Computed Tomography

A 61 years obese gentleman presented early with gain of weight and lump in the left side of abdomen for 15 days. On contrast enhanced computed tomography (CECT) of abdomen, a giant renal mass arising from left kidney. Patient underwent open nephrectomy, surgically removed en bloc of 12.5 kg weight largest renal mass. Histopathology showed papillary renal cell carcinoma. The postoperative period was uneventful.

scholarly journals Postoperative bleeding in a patient with appendiceal mucinous adenocarcinoma and liver dysfunction patient: A case-report

2021 ◽  
Author(s):  
MingKun Sun ◽  
Xiaohua Niu ◽  
Ying Tang ◽  
Wenzhong Mo ◽  
Haiyang Xin ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Liver Dysfunction ◽  
Mucinous Adenocarcinoma ◽  
Malignant Tumors ◽  
Postoperative Bleeding ◽  
Pathological Examination ◽  
Preoperative Imaging ◽  
Intraperitoneal Hyperthermic Chemotherapy ◽  
Hyperthermic Chemotherapy ◽  
Enhanced Computed Tomography

Abstract Background: Appendiceal malignant tumors are rare in the clinic, and the incidence rate of gastrointestinal tumors is only approximately 0.5%. Our aim is to describe our experience with this rare disease and to increase knowledge on the diagnosis and treatment of appendiceal malignant tumors. Case presentation: We report the case of a 69-year-old woman who was admitted to the hospital due to dyspepsia. The patient was a carrier of hepatitis B virus, and liver dysfunction was diagnosed preoperatively. Abdominal enhanced computed tomography and colonoscopy showed that the appendix was significantly enlarged and dilated, and effusion and appendicitis were observed. Mucinous adenocarcinoma and appendiceal abscesses were not excluded because of the lack of specificity, which makes it difficult to diagnose the disease before a surgery. Laparoscopic appendectomy was performed, and a rapid frozen pathological examination showed a mucinous tumor of the appendix. Intraperitoneal hyperthermic chemotherapy with cisplatin was administered. The patient had abdominal hemorrhage on the fifth day after the surgery. After active treatment, she was discharged from the hospital 19 days after the surgery.Conclusions: The diagnosis of appendiceal malignant tumors mainly depends on preoperative imaging and microscopic results,and highly suspected patients, rapid pathological examination is needed during the operation., and so on. Notably, for elderly patients with hepatitis B infection and liver dysfunction, there is a probability of postoperative bleeding.

scholarly journals Primary leiomyoma of the ureter: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Shingo Morinaga ◽  
Shigeyuki Aoki ◽  
Motoi Tobiume ◽  
Genya Nishikawa ◽  
Hiroyuki Muramatsu ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Histopathological Examination ◽  
Urine Cytology ◽  
Benign Tumors ◽  
Case Presentation ◽  
Old Japanese ◽  
Retrograde Pyelogram ◽  
History Of ◽  
The Right ◽  
Enhanced Computed Tomography

Abstract Background Only 14 cases of leiomyoma with ureteral origin have been reported previously. Such primary leiomyomas often present as hydronephrosis, making the diagnosis difficult. Radical nephroureterectomy is often performed because of the possible diagnosis of a malignant tumor. We report the 15th case of primary leiomyoma with a ureteral origin. Case presentation A 51-year-old Japanese man presented with a chief complaint of asymptomatic gross hematuria with a history of hypertension. Enhanced computed tomography showed a tumor at the upper part of the right ureter that appeared to be the cause of hydronephrosis and contracted kidney; no retroperitoneal lymphadenopathy and distal metastasis were observed. A well-defined 20-mm (diameter) defect was identified at the upper of the right ureter on retrograde pyelogram with no bladder cancer on cystoscopy. Urine cytology and right divided renal urine cytology findings were negative. Laparoscopic nephroureterectomy was performed, and the extracted tumor measured 20 × 13 mm. Histopathological examination revealed primary leiomyoma with no recurrence 16 months after the operation. Conclusions Preoperative examination with the latest available ureteroscopic technology can help preserve renal function in the case of benign tumors by enabling preoperative ureteroscopic biopsy or intraoperative rapid resection. Moreover, nephroureterectomy is recommended in the case of preoperative suspicion of ureteral malignant tumors.

scholarly journals Combined method for differential diagnosis of pancreatic cystic neoplasm

2019 ◽  
Vol 17 (6) ◽  
pp. 27-34
Author(s):  
A. P. Koshel ◽  
E. S. Drozdov ◽  
T. N. Dibina ◽  
S. S. Klokov ◽  
E. B. Mironova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Malignant Tumors ◽  
Statistical Significance ◽  
Serum Levels ◽  
Cystic Neoplasm ◽  
Combined Method ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Sensitivity Specificity ◽  
Diagnostic Criterion

Objective. The frequency of detection of cystic neoplasm of the pancreas (CNP) has recently increased. Some of these neoplasms are benign, while others are malignant. Differential diagnosis between benign and malignant CNP remains challenging.Aim: to develop a combined method for differential diagnosis of CNP and to evaluate the role of the neutrophil to leukocyte ratio (NLR) as a diagnostic criterion of malignant CNP.Material and Methods. A retrospective analysis of the treatment of 82 patients with CNP, who underwent surgery between 2008 and 2018, was carried out. Benign lesions were detected in 62 patients and malignant tumors were diagnosed in 20 patients. The NLR and the serum levels of CA 19-9 as well as the presence of intracystic lesions were assessed as predictors of malignant CNP.Results. The presence of intracystic lesions detected by contrast-enhanced computed tomography and the elevated levels of serum CA 19-9 (>39 U/mL) and NLI (>1.876) were proven to be independent predictors of malignant CNP with statistical significance. The combination of all three criteria indicated malignant cystic neoplasm. The sensitivity, specificity and overall accuracy of the combined method were 71.4 %, 95.6 % and 86.5%, respectively.Conclusions. The combined method for differential diagnosis of malignant CNP is easy to use and has high accuracy. There is a direct correlation between NLI and malignant CNP.

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