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2.1
Renal Pelvic Calculus
Renal Calculus Pelvis

Presentation

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]

It is also helpful to be aware of the patient's clinical presentation and history. [wikiradiography.com]

[…] 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]

Fig. 4.11 Multiple millimetric radiopaque renal stones ( arrow ) and a large proximal ureter stone ( arrowhead ) are present on the right side. [radiologykey.com]

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]

    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]

    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]

  • Hunting

    ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt [en.wikipedia.org]

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]

    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]

  • Hematuria

    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]

    He had 2 additional episodes of severe hematuria with clots, despite conservative management. The urine was clear between the hematuria episodes. [hindawi.com]

    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]

    Clinically, presenting symptoms contain hematuria, loin pain, abdominal lump and so on. Both two cases had flank pain and microscopic hematuria. [omicsonline.org]

    Teach the patient to report any signs of complications, such as fever, chills, or hematuria, as well as any changes in urinary output patterns, to the primary caregiver. [medical-dictionary.thefreedictionary.com]

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]

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]

The treatment of stones within anteriorly positioned diverti-cula can be technically challenging. [alpfmedical.info]

[…] of the kidneys precluding treatment with ureteroscopy. [miamiurologyconsultants.com]

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

Both congenital and acquired factors have been implicated in its etiology [3]. [ijri.org]

[…] 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]

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 [ 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. 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, 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]

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]

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]

Diuretics may be ordered to prevent urinary stasis. [medical-dictionary.thefreedictionary.com]

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