Presentation
[…] stone Present bilateral Present bilateral Present unilateral Present bilateral Previous history of stone surgery Absent Present Absent Present Hydronephrosis with nonfunctioning kidney Present Present Present Present Procedure Right nephrectomy Left [hindawi.com]
Case Report Mr A.Z is a 57-year-old man who presented with recurrent intermittent colicky right flank pain of a-year duration initially at a private hospital in Lokoja. At initial presentation, there was associated nausea and vomiting. [wajradiology.org]
Fig. 4.11 Multiple millimetric radiopaque renal stones ( arrow ) and a large proximal ureter stone ( arrowhead ) are present on the right side. [radiologykey.com]
A patient who presents with recurrent renal colic after stent removal should usually be worked up as a new presentation of renal colic, with urinary dipstick and imaging, and managed as per previous suggestions. [racgp.org.au]
Entire Body System
- Chills
In cases in which a urinary tract infection is also present, the patient may report chills and fever. Determine the patient’s history to identify risk factors. [medical-dictionary.thefreedictionary.com]
The following may be signs of kidney stones that need a doctor's help: Extreme pain in your back or side that will not go away Blood in your urine Fever and chills Vomiting Urine that smells bad or looks cloudy A burning feeling when you urinate Your [icdlist.com]
Other symptoms include restlessness, blood in the urine, nausea, vomiting, discolored urine, bad-smelling urine, chills, fever, difficulty urinating, or frequently feeling the urge to urinate but only producing a small amount. [study.com]
A patient with kidney stones may present with flank pain on one or both sides, back pain, nausea and vomiting, urinary frequency, painful urination, abdominal pain, chills, and/or fever. [fortherecordmag.com]
- Sepsis
For example, sepsis in conjunction with an obstructing stone represents a true emergency. [aafp.org]
If the urine behind the stone becomes infected it may manifest as a fever and can lead to sepsis and even death if the obstruction is not relieved by a stent or a percutaneous nephrostomy tube. [miamiurologyconsultants.com]
Untreated UTIs may lead to more serious conditions such as pyelonephritis, an infection of the kidney, and sepsis, an infection in the bloodstream or blood poisoning. Hydronephrosis isn’t a disease. [healthline.com]
demonstrates staghorn calculus ( arrow ) in the right kidney. ( b ) Retrograde pyelography reveals staghorn calculus involving the middle and lower pole calyces of the right kidney. ( c ) Nephrectomy specimen, bivalved, from a patient with recent sepsis [radiologykey.com]
– Any renal or ureteral stone up to 1.9cm – Recommended first line for mid and distal ureteral stones – Cystine or uric acid stones – 85–97% for any steon up to 1cm – 79% for proximal ureteral stones >1cm – Ureteral perforation – Ureteral avulsion – Sepsis [auanet.org]
- Anemia
Renal papillary necrosis is associated with other conditions, such as, diabetes mellitus, sickle cell anemia, etc. and the cyst or cavities are in the medullary area and represent deformed calyces [2], [5]. [ijri.org]
View Article : Google Scholar : PubMed/NCBI 14 Hui Wu J, Xu Y, Qiang Xu Z, Yang K, Qiang Yang S and Shun Ma H: Severe anemia and melena caused by pyeloduodenal fistula due to renal stone-associated squamous cell carcinoma. [spandidos-publications.com]
Gastrointestinal
- Abdominal Pain
flank pain, upper abdominal pain Middle section of ureter Renal colic, anterior abdominal pain, flank pain Distal ureter Renal colic, dysuria, urinary frequency, anterior abdominal pain, flank pain Distal ureteral stones may be manifested by bladder [aafp.org]
pain May produce paraneoplastic syndrome with hypercalcemia, similar to squamous carcinoma of lung ( Urology 2014;84:8 ) Clinical images Images hosted on other servers: Coronal and axial ultrasound Computed tomography Solitary mass lower right kidney [pathologyoutlines.com]
The condition causes constipation, vomiting, abdominal pain, abdominal swelling, loss of appetite, and an inability to have a bowel movement or pass gas. [onhealth.com]
In the brain, vomiting, fever, blood urine, urinary trauma. kidney abdominal pain every minute and minus walking, which is either under the party or under and usually starts at 20-60 or lowering the neck or prolificity Is there. [arogyadhamhcc.com]
Document reports of increased and persistent abdominal pain. Complete obstruction of ureter can cause perforation and extravasation of urine into perirenal space. This represents an acute surgical emergency. Apply warm compresses to back. [nurseslabs.com]
- Flatulence
Excessive accumulation of flatulence, lower abdomen. > warm food & drinks. Sarsaparilla Passage of small calculi or gravel, renal colic, stone in the bladder. Excruciating pains from right kidney downwards. [homeobook.com]
Musculoskeletal
- Hip Pain
Polygonum Sagittatum Pains of nephritic colic, lancinating pain along spine. Suppurative nephritis. Aching pain in hips & loins. Polygonum Persicaria Renal colic & calculi. Nitromuriatic Acid Gravel. Oxaluria, almost a specific. [homeobook.com]
A 19 year old woman comes to the physician because of increasingly severe pain in the right hip during the past month. [forums.studentdoctor.net]
Urogenital
- Flank Pain
Acute flank pain: Comparison of non-contrast-enhanced CT and intravenous urography. Radiology 1995;194:789-94. 9. Fielding JR, Steele G, Fox LA, Heller H, Loughlin KR. [wajradiology.org]
Presentation Left flank pain Patient Data Age: 25 Gender: Male 2 case questions available Loading images... [radiopaedia.org]
- Hematuria
He had 2 additional episodes of severe hematuria with clots, despite conservative management. The urine was clear between the hematuria episodes. [hindawi.com]
Hematuria / Renal Stone What is the differential for hematuria? Trauma Renal calculi Renal cancer Bladder stone or cancer Acute glomerulonephritis Imaging workup of renal cancer and trauma is discussed elsewhere. [meddean.luc.edu]
Clinically, presenting symptoms contain hematuria, loin pain, abdominal lump and so on. Both two cases had flank pain and microscopic hematuria. [omicsonline.org]
Hematuria, or blood in the urine, is also a common symptom of kidney stones. However, since hematuria is usual with kidney stones, it should not be assigned as a secondary diagnosis. [fortherecordmag.com]
Approximately 85% of all patients with renal colic demonstrate at least microscopic hematuria, which means that 15% of all patients with kidney stones do not have hematuria. [emedicine.medscape.com]
- Dysuria
Painful dysuria. Involuntary green urine. Cystitis with bloody urine. Coccus cacti Urinary calculi, urates & uric acid. Brick red sediment. Haematuria. Deep coloured thick urine. Dysuria, urging to urinate. Lancinating pains from kidneys to bladder. [homeobook.com]
Nausea, Vomiting, Urinary frequency/urgency, Haematuria (blood in the urine), Abdominal pain, Dysuria (painful urination), Nocturia (excessive at night), Urinary hesitancy, Fever, Chills and Abnormal urine color or smell. [healthengine.com.au]
urinary frequency, anterior abdominal pain, flank pain Distal ureteral stones may be manifested by bladder instability, urinary frequency, dysuria and/or pain radiating to the tip of the penis, or the labia or vulva. [aafp.org]
Stents frequently cause dysuria and urinary frequency, with a constant feeling of urgency. Unless a urine culture is also positive, this is unlikely to represent a UTI. [racgp.org.au]
"Ovulatory dysuria: a bizarre presentation of crossed non fused ectopic kidney with extrarenal pelvis." Int Urogynal Nephrol 40(4): 889-892. PubMed | CrossRef Birmole, B. J., S. S. Borwankar, et al. (1993). "Crossed renal ectopia." [urotoday.com]
- Renal Injury
We compared the results of laparoscopic and open surgery in terms of easy accessibility, operative period, renal injuries, and early recovery. Methods. [clujulmedical.umfcluj.ro]
Renal injury by extracorporeal shock wave lithotripsy J Endourol 1991 5 : 25–35 5 Xenocostas A et al. [nature.com]
SPECIAL CIRCUMSTANCES Solitary Kidney and Renal Insufficiency Both SWL and PNL are known to produce short-term renal injury. [scielo.br]
Workup
Trauma Renal calculi Renal cancer Bladder stone or cancer Acute glomerulonephritis Imaging workup of renal cancer and trauma is discussed elsewhere. [meddean.luc.edu]
This important workup can guide the physician to prescribe medications that can decrease the risk or stone formation in the future. [miamiurologyconsultants.com]
The patient had an uneventful postoperative course but was lost to follow up after discharge from the hospital before his metastatic workup could be performed. Case 2. [hindawi.com]
Necessary workup includes a midstream clean catch or catheterized urine specimen for urinalysis and microscopy with urine culture as indicated, CBC to assess for leukocytosis, and creatinine to assess for any rise above the patient’s baseline. [auanet.org]
[…] calculus Nuclear renal scanning: To objectively measure differential renal function, especially in a dilated system for which the degree of obstruction is in question; reasonable study in pregnant patients, in whom radiation exposure must be limited See Workup [emedicine.medscape.com]
Laboratory
- Leukocytosis
Necessary workup includes a midstream clean catch or catheterized urine specimen for urinalysis and microscopy with urine culture as indicated, CBC to assess for leukocytosis, and creatinine to assess for any rise above the patient’s baseline. [auanet.org]
The presence of pyuria, fever, leukocytosis, or bacteriuria suggests the possibility of a urinary infection and the potential for an infected obstructed renal unit or pyonephrosis. [emedicine.medscape.com]
Treatment
This question featured in : Non obstructing calculus Renal calculus treatment Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. [practo.com]
Surgery is the mainstay of treatment for a PUJ obstruction. [steinerurology.com.au]
Plentiful treatment methods have been tried in patients who suffer from renal SCC. The treatment approaches should be selected on the basis of age, the patient’s general condition, grading and staging of the cancer and patient compliance and so on. [omicsonline.org]
[…] the surgical treatment for nephrolithiasis. [scielo.br]
Prognosis
The prognosis of renal SCC is relatively poor. [omicsonline.org]
Treatment and prognosis Staghorn calculi need to be treated surgically, usually PCNL (percutaneous nephrolithotomy) +/- ESWL (extracorporeal shockwave lithotripsy) and the entire stone removed, including small fragments, as otherwise, these residual fragments [radiopaedia.org]
This type of surgery has changed the prognosis for staghorn calculi and multiple calculi cases obtaining a total extraction with no injury to the renal parenchyma, and no trauma to the excretory tract. [karger.com]
Wright et al ( 19 ) identified that urachal cancer possessed a significantly better prognosis than non-urachal cancer, while Mostofi et al ( 20 ) hypothesized that urachal adenocarcinomas were associated with a significantly worse prognosis. [spandidos-publications.com]
Etiology
[…] squamous differentiation Epidemiology Very rare tumor, except for patients with nonfunctioning hydronephrotic kidney due to renal pelvic stone disease ( Mol Clin Oncol 2015;3:941 ) Approximately equal men and women, age 50 - 70 years ( J Urol 2007;178:51 ) Etiology [pathologyoutlines.com]
Both congenital and acquired factors have been implicated in its etiology [3]. [ijri.org]
CONTENTS Definition Incidence Etiology Risk factors Types of renal stones Pathophysiology November5,2017 3 4. [slideshare.net]
[…] with serum and 24-hour urine metabolic evaluation, can identify an etiology in more than 95% of patients. [emedicine.medscape.com]
Epidemiology
[…] urothelial differentiation (invasive or in situ) and not combined with another renal neoplasm Terminology Cases with associated urothelial carcinoma or urothelial carcinoma in situ are best classified as urothelial carcinoma with squamous differentiation Epidemiology [pathologyoutlines.com]
Kidney stones epidemiology. Nephrology 2007;12(Suppl 1):S26–30. Bove P, Kaplan D, Dalrymple N, et al. Reexamining the value of hematuria testing in patients with acute flank pain. J Urol 1999;162(3 Pt 1):685–87. [racgp.org.au]
Epidemiology. In : Segura J, Conort P, Khoury S, eds. Stone disease Proceedings of the 1st International Consultation on Stone Disease; 2001 Jul 4-5; Paris, France. Paris. EDITIONS 21. 2003. p. 13–29. 5. Bronner F, Pansu D. [jsms.sch.ac.kr]
Epidemiology [ 2 ] Renal stones are common, being present at some time in one in ten of the population, although a significant proportion will remain asymptomatic. [patient.info]
Epidemiology, origin, pathophysiology, diagnosis, and management. Radiol Clin North Am. 1999;37:911–52v. 14. Chen MY, Zagoria RJ. [aafp.org]
Pathophysiology
PATHOPHYSIOLOGY November5,2017 31 32. November5,2017 32 33. November5,2017 33 34. [slideshare.net]
Adventitial inflammatory infiltrate is present.[18] However, the degradation of the tunica media by means of a proteolytic process seems to be the basic pathophysiologic mechanism of AAA development. [en.wikipedia.org]
Epidemiology, origin, pathophysiology, diagnosis, and management. Radiol Clin North Am. 1999;37:911–52v. 14. Chen MY, Zagoria RJ. [aafp.org]
Pathophysiology Urinary calculi may have various compositions which include, in order of decreasing frequency: calcium oxalate, uric acid, struvite or infection (triple phosphate = magnesium ammonium calcium phosphate), calcium phosphate and cystine. [auanet.org]
Prevention
Can Kidney Stones Be Prevented? It's not always possible to prevent some types of kidney stones. But anyone who's had kidney stones should: Drink a lot of liquids (water is best) throughout the day. Avoid dark sodas, soft drinks, and sports drinks. [kidshealth.org]
Prevention When kidney stones are treated without doing anything about the cause, they often come back. The most suitable type of prevention will then depend on what the kidney stones are made of and what caused them. [ncbi.nlm.nih.gov]
Vigorous hydration promotes passing of stone, prevents urinary stasis, and aids in prevention of further stone formation. Document reports of increased and persistent abdominal pain. [nurseslabs.com]
Intervention(contd…) Maintain sterile technique to prevent infection because the tube goes directly into the kidney. Teach the client about any type of catheter care (how to clean around them, empty them, prevent kinking and irrigate them) before [slideshare.net]