unilateral hydronephrosis
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2021 ◽  
Vol 33 (2) ◽  
pp. 94-97
Author(s):  
Md Asaduzzaman ◽  
SM Abdullah ◽  
Mohammad Abu Hanif ◽  
Md Hasanuzzaman ◽  
Rifat Naoreen Islam ◽  
...  

Introduction: The most common upper urinary tract problem in children is obstruction at the pelviureteric junction. It happens with varying degrees of seriousness. Ultrasonography and DTPA (Diethylene Triamine Penta-acitic Acid) renography are commonly used to detect it. Objective: To find out the coexistence of ipsilateralpelviureteric junction obstruction with vesicourenteral reflux. Materials and Methods: This prospective study was conducted in the Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2006 to May 2007 over a period of 1 year 5 months. Thirty-five patients with unilateral hydronephrosis due to PUJ obstruction were included in this study (age: 1 month-15 years). Results were analyzed using Statistical Package for Social Science (SPSS). Results: Incidence of Vesicoureteral reflux (VUR) among pelviureteric junction (PUJ) obstruction patients was 8.6%. Of them Grade-I VUR was 33.3% and grade-II VUR was 66.7%. Mean age of the patients was 4.71 ± 1.97 years and with VUR was 9.33 ± 4.93 years. Male to female ratio was 4:1. Only 5.7% mothers had regular antenatal checkup and 28.5% had irregular. Majority of the patients 28 (80%) were presented with painless loin mass, 6 (17.1%) with fever, 8 (22.9%) with loin pain and 8 (22.9%) with failure to thrive. Three patients (8.6%) showed abnormal R/M/E and all of the abnormal R/M/E samples showed positive culture. Conclusions: Incidence of Vesicoureteral reflux (VUR) among pelviureteric junction (PUJ) obstruction patients was 8.6%. Medicine Today 2021 Vol.33(2): 94-97


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yojiro Ishikawa ◽  
Rei Umezawa ◽  
Takaya Yamamoto ◽  
Noriyoshi Takahashi ◽  
Kazuya Takeda ◽  
...  

Abstract Background Desmoid-type fibromatosis is a rare disease that can result in hydronephrosis. Hydronephrosis associated with desmoid-type fibromatosis often requires surgery or ureteral stent insertion. Although radiation therapy is recommended for inoperable cases of desmoid-type fibromatosis, there has been no report of treatment for hydronephrosis associated with desmoid-type fibromatosis by radiation therapy alone. We herein report a case of successful treatment for inoperable recurrence of desmoid-type fibromatosis with unilateral hydronephrosis by radiation therapy alone. Case presentation A 43-year-old Japanese female underwent resection of desmoid-type fibromatosis in the right inguinal region and combined resection of the right external iliac vein 5 years before. Other treatment was not performed because of her pregnancy. Four years after surgery, desmoid-type fibromatosis recurred in the right pelvic wall. Cyclooxygenase-2 selective inhibitor treatment was given for 1 year, but her desmoid-type fibromatosis enlarged to more than 10 cm, and she had swelling of her right leg and hydronephrosis of her right kidney. The patient received 50.4 Gy in 28 fractions of prophylactic irradiation using 10 MV X-ray and 9 Gy in five fractions of a sequential boost for the recurrent desmoid-type fibromatosis. Although there was temporary tumor progression at 1 month after radiation therapy, slow regression of the tumor was seen. At 5 years after radiation therapy, there was no disease progression or severe complications. Conclusion We experienced successful treatment for an inoperable case of desmoid-type fibromatosis with hydronephrosis. Moderate-dose radiation therapy alone is an effective and feasible approach for the management of hydronephrosis associated with desmoid-type fibromatosis.


2021 ◽  
Vol 11 (3) ◽  
pp. 459-466
Author(s):  
Peter Ferkis Steinfeld ◽  
Thomas Knoop ◽  
Linn Hereide Trovik ◽  
Hilde Kollsete Gjelberg ◽  
Torjan Magne Haslerud ◽  
...  

Although rare, acute myelogenous leukemia (AML) can include extramedullary manifestations, sometimes presenting as a solid tumor called a myeloid sarcoma. Myeloid sarcoma can be the cause of the initial presenting complaint before AML diagnosis, or may be detected as a sign of disease-relapse after treatment. Here, we report a case in which the initial presentation included abdominal discomfort and signs of kidney failure. Further investigation revealed signs of unilateral hydronephrosis. Due to a diagnostic delay, the patient was diagnosed with AML with extramedullary manifestation only after the development of full-blown leukemia. Biopsy of the compressive tumor confirmed an extramedullary myeloid sarcoma, and [18F]-FDG-PET/CT proved useful for patient diagnosis and follow-up. This case report illustrates the importance of thorough examination and diagnosis, as a serious underlying disease with a rare cause can debut with an unusual presentation.


Author(s):  
David M. Sherer ◽  
Vicky Hsieh ◽  
Mila Kheyman ◽  
Alessia Field ◽  
Mudar Dalloul

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Joelle Suillot ◽  
Jürg Bollmann ◽  
Samuel Rotman ◽  
Eric Descombes

Ureteral stenosis is a rare manifestation of granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis). We report the case of a 76-year-old woman with progressive renal failure in which bilateral hydronephrosis due to ureteral stenosis was the first manifestation of the disease. Our patient also had renal involvement with pauci-immune crescentic glomerulonephritis associated with high titers of anti-proteinase 3 c-ANCAs, but no involvement of the upper or lower respiratory tract. The hydronephrosis and renal function rapidly improved under immunosuppressive therapy with high-dose corticosteroids and intravenous pulse cyclophosphamide. We reviewed the literature and found only ten other reported cases of granulomatosis with polyangiitis/Wegener’s granulomatosis and intrinsic ureteral stenosis: in two cases, the presenting clinical manifestation was unilateral hydronephrosis and in only two others was the hydronephrosis bilateral, but this complication developed during a relapse of the disease. This case emphasizes the importance of including ANCA-related vasculitis in the differential diagnosis of unusual cases of unilateral or bilateral ureteral stenosis.


2020 ◽  
Vol 75 (6) ◽  
pp. 617-630
Author(s):  
V. V. Rostovskaya ◽  
N. А. Кhvatynets ◽  
G. I. Kuzovleva ◽  
К. М. Matyushina

Background. One of the main reasons for the incorrect differentiation of obstructive and non-obstructive disorders of the upper urinary tract (UUT) is age-related morphofunctional immaturity of the kidney and its structures in children of the first three years of life. Aims to investigate to determine the peculiarities of urodynamic disorders of the UUT in infants with congenital hydronephrosis using diuretic pyeloehography (DРG) method. Methods. There were studied DPG data of 55 patients aged 336 months with unilateral hydronephrosis of IIII grades SFU, which were divided into groups in accordance with the variant of violation of the urodynamics of the UUT (obstructive, obstructive-hypertensive and disadaptive). The variants established according to the parameters of the DPG (transient coefficient PUJ (Kpus), the coefficients of postfurosemide adaptation (Ka) and the efficiency of emptying (Ko) pelvis). The obtained data are compared with the conclusions of morphometric studies of the operated 20 children with ureteropelvic junction obstruction (UPJO). Results. The obstructive-hypertensive variant was determined in 18 patients, obstructive in 20, and disadaptive in 17. The severity of pelvic dysfunction (according to Ka and Ko) did not correlated to the grade of UPJO (according Kpus) in most cases. Intergroup and intragroup variability in the values of the DРG coefficients is confirmed by the results of PUJ and pelvis morphometry. The correlation between hystological modification in the pelvis and DPG parameters was revealed. Obtained data allowed to introduce a new indicator urodynamic indicator of quantitative assessment of functional insufficiency of the UUT. And the score gradation of each DРG coefficient (from 0 to 4 points) in accordance with deviation from the reference values was developed. The total indicator functional insufficiency is expressed by the sum of points (SP) for each coefficient (Ka, Ko, Kpus). When SP is less than 3 points light, 46 moderate, 79 expressed and 1012 severe grade of violation of urodynamics. The severity of dysfunctions of the UUT in 88% of children (n = 15) with a disadaptive variant corresponded to light degree, in 75% of patients (n = 14) with an obstructive-hypertensive variant expressed (50%) and severe (25%) grades. Moderate degree of dysfunction revealed in 65% of patients (n = 13) with an obstructive variant. Conclusion. The severity of urodynamic dysfunction of the UUT in this age group can be determined by the score gradation of the DPG parameters which reflects the functionality of the pelvis/PUJ and the grade of their violation adaptive reactions in response to diuretic.


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