Intermittent hydronephrosis in childhood

2013 ◽  
Vol 154 (24) ◽  
pp. 940-946 ◽  
Author(s):  
Miklós Merksz ◽  
Bálint Sulya ◽  
Mária Polovitzer ◽  
Ildikó Héjj ◽  
Diana Molnár ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Medical Records ◽  
Abdominal Ultrasound ◽  
Recurrent Abdominal Pain ◽  
Final Diagnosis ◽  
Occurrence Rate ◽  
Unknown Etiology ◽  
Delay In Diagnosis ◽  
Pelviureteric Junction Obstruction ◽  
Difficult Condition

Introduction: Intermittent pelviureteric junction obstruction, and its consequence,intermittent hydronephrosis is a difficult condition to identify. The renal collecting system is not dilated between the episodes of abdominal pain attacks and a prompt investigation is hard to carry out during the time of painful crisis. Therefore, most of the patients are initially misdiagnosed. Aim: The aim of the study was to assess the occurrence and the clinical characteristics of this phenomenon in children operated in the Department of Urological Surgery, Heim Pál Children Hospital, Budapest, Hungary. Patients and methods: Medical records of children operated for hydronephrosis between 2008 and 2012 were reviewed. The occurrence rate and clinical features of intermittent hydronephrosis were analyzed. Results: 76 children were operated for pelviureteric junction obstruction, of which 10 met the criteria of intermittent hydronephrosis. The average interval between the onset of symptoms and the final diagnosis was 2 years and 4 months. In 7 patients pyeloplasty, and in 3 patients nephrectomy were performed. Conclusions: Intermittent hydronephrosis represents a well-defined proportion among cases operated for hydronephrosis. The delay in diagnosis led to the loss of the kidney in one third of the patients, and this finding urges for the awareness of health professionals for this phenomenon. In case of recurrent abdominal pain of unknown etiology one must suspect a urological origin, even if a previous abdominal ultrasound showed normal kidneys. Orv. Hetil., 2013, 154, 940–946.

scholarly journals Refractory Abdominal Pain in a Patient with Chronic Lymphocytic Leukemia: Be Wary of Acquired Angioedema due to C1 Esterase Inhibitor Deficiency

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Abdullateef Abdulkareem ◽  
Ryan S. D’Souza ◽  
Joshua Mundorff ◽  
Pragya Shrestha ◽  
Oluwaseun Shogbesan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Chronic Lymphocytic Leukemia ◽  
Upper Airway ◽  
Recurrent Abdominal Pain ◽  
Final Diagnosis ◽  
Lymphocytic Leukemia ◽  
C1 Inhibitor Deficiency ◽  
Acquired Angioedema ◽  
C1 Esterase Inhibitor ◽  
Esterase Inhibitor

Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions. In this article, we present the case of a 62-year-old male with a history of recently diagnosed chronic lymphocytic leukemia (CLL) who presented to our hospital with recurrent abdominal pain, initially suspected to haveClostridium difficilecolitis and diverticulitis. He received a final diagnosis of acquired angioedema due to C1 esterase inhibitor deficiency due to concomitant symptoms of lip swelling, cutaneous nonpitting edema of his lower extremities, and complement level deficiencies. He received acute treatment with C1 esterase replacement and icatibant and was maintained on C1 esterase infusions. He also underwent chemotherapy for his underlying CLL and did not experience further recurrence of his angioedema.

scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

scholarly journals Recurrent Right Upper Quadrant Pain Masquerading an Underlying Colon Adenocarcinoma-Induced Intussusception

2021 ◽  
pp. 501-506
Author(s):  
Zeena Ayad Qiryaqoz ◽  
Urvashi Katiyar ◽  
Saad Shebrain
Keyword(s):  
Abdominal Pain ◽  
Surgical Intervention ◽  
Colon Adenocarcinoma ◽  
Unknown Origin ◽  
Recurrent Abdominal Pain ◽  
Quadrant Pain ◽  
Rare Presentation ◽  
Delay In Diagnosis ◽  
Therapeutic Outcomes ◽  
High Degree

Intussusception in adults is a challenging diagnosis that often requires a high degree of suspicion. In adults presenting with symptoms, almost 90% have underlying neoplasms. Most frequently, the presentation will include nonspecific abdominal pain, vomiting, and mucoid hematochezia. In this case, we present a 39-year-old female with a rare presentation of chronic, recurrent right upper quadrant abdominal pain over a 5-month interval. The misleading presentation with which the patient presented led to a delay in diagnosis and treatment of colon malignancy and serves to advocate for intussusception as a differential for adult patients presenting with obstructive symptoms of unknown origin and recurrent abdominal pain. Such cases should persuade physicians to plan prompt surgical intervention as to not delay optimal diagnostic and therapeutic outcomes.

scholarly journals Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2123
Author(s):  
Wonshik Kim ◽  
Beomjae Lee ◽  
Ahyoung Yoo ◽  
Seunghan Kim ◽  
Moonkyung Joo ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Capsule Endoscopy ◽  
Meta Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Recurrent Abdominal Pain ◽  
Video Capsule Endoscopy ◽  
Unknown Etiology ◽  
Diagnostic Modality ◽  
Ulcerative Lesions

Video capsule endoscopy (VCE) is an effective diagnostic modality for detecting small bowel lesions. However, the value of VCE for patients with chronic recurrent abdominal pain (CAP) of unknown etiology remains obscure. We retrospectively analyzed factors that could predict enteropathy based on the medical records of 65 patients with unexplained chronic recurrent abdominal pain (CAP) who were assessed using VCE between 2001 and 2021. We also conducted a systematic review and meta-analysis of the literature to validate our results. The positive findings of 27 (41.5%) of the 65 patients were mostly ulcerative lesions including stricture (n = 14, 60.9%) and erosion (n = 8, 29.7%). Multivariate analysis identified elevated ESR (OR, 1.06, 95% CI, 1.02–1.1, p = 0.004) as a significant risk factor for enteropathy predicted by VCE. Three eligible studies in the meta-analysis included 523 patients with CAP. Elevated C-reactive protein (CRP) (OR, 14.09; 95% CI, 2.81–70.60; p = 0.001) and erythrocyte sedimentation rate (ESR) (OR, 14.45; 95% CI, 0.92–227.33; p = 0.06) indicated VCE-positive findings in patients with unexplained abdominal pain. Elevated levels of the inflammatory markers ESR and CRP can thus predict positive VCE findings in patients with CAP.

Ureteropelvic Junction Obstruction Presenting With Recurrent Abdominal Pain: Diagnosis by Ultrasound

PEDIATRICS ◽  
1985 ◽  
Vol 76 (6) ◽  
pp. 934-937
Author(s):  
William J. Byrne ◽  
Watson C. Arnold ◽  
Michael W. Stannard ◽  
John F. Redman
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Radiation Exposure ◽  
Ureteropelvic Junction Obstruction ◽  
Correct Diagnosis ◽  
Abdominal Ultrasound ◽  
Recurrent Abdominal Pain ◽  
Ureteropelvic Junction ◽  
Contrast Radiography ◽  
Normal Ultrasound

Three cases of ureteropelvic junction obstruction are presented in which the only symptom was recurrent abdominal pain. Results of physical examination and urinalysis were normal. Ultrasound established the correct diagnosis in the two patients in whom it was performed. Because it is safe, involves no radiation exposure, and is useful in evaluating the gallbladder, pancreas, and liver, as well as both kidneys, abdominal ultrasound should be performed prior to contrast radiography in the evaluation of children with recurrent abdominal pain.

scholarly journals PANCREATIC METAPLASIA OF THE GASTRIC MUCOSA IN CHILD

2016 ◽  
Vol 65 (3) ◽  
pp. 276-278
Author(s):  
Raluca Damian ◽  
◽  
Cristina Oana Marginean ◽  
Nicoleta Suciu ◽  
Maria Oana Marginean ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Gastric Mucosa ◽  
Abdominal Ultrasound ◽  
Recurrent Abdominal Pain ◽  
Pancreatic Tissue ◽  
Personal History ◽  
Antral Mucosa ◽  
Digestive Endoscopy ◽  
A Value ◽  
Associated Lesions

Pancreatic metaplasia is defined as the development of pancreatic tissue in an abnormal location and without direct connection to the pancreas. The heterotopic pancreatic tissue is most frequently noticed in the antral gastric mucosa, duodenum and jejunum. We present the case of a 13-year-old patient, admitted in Pediatrics Clinic 1 Targu-Mures, for recurrent abdominal pain and heartburns. The laboratory tests pointed out lymphocytosis (41%) with monocytosis (8.9%), eosinophilia (4.9%), an increased number of reticulocytes (20%), a decreased serum level of triglycerides and a value above the superior limit for calcium and magnesium. The abdominal ultrasound did not reveal any pathological modifications. The superior digestive endoscopy showed a granular gastric mucosa, therefore we took a biopsy of the antral mucosa, The pathological exam pointed out a fragment of pancreatic metaplasia in the antral gastric mucosa. The evolution was favorable with diet and treatment for the associated lesions. The particularity of the case consists in the presence of pancreatic metaplasia of the gastric mucosa in a patient with recurrent abdominal pain and heartburns, without significant familial or personal history.

scholarly journals Sarcoidosis presenting with splenomegaly and abdominal pain: a case report

2012 ◽  
Vol 6 (3) ◽  
pp. 91-96
Author(s):  
Clara Faini ◽  
Natalia Manetti ◽  
Francesca Bucciero ◽  
Giulia Razzolini ◽  
Maria Marsico ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lymph Nodes ◽  
Granulomatous Inflammation ◽  
Abdominal Ultrasound ◽  
Lung Parenchyma ◽  
Final Diagnosis ◽  
Skin Lesions ◽  
Mild Renal Impairment ◽  
Bilateral Hilar Lymphadenopathy ◽  
Noncaseating Granulomas

Sarcoidosis is a multisystemic disease of unknown aetiology characterized by proliferation of noncaseating granulomas at disease sites. It commonly affects young and middle-age adults and frequently presents with pulmonary infiltration, bilateral hilar lymphadenopathy, ocular and skin lesions. The liver, spleen, lymph nodes, salivary glands, heart, nervous system, muscles, bones, and other organs may also be involved. A diagnosis of the disorder usually requires the demonstration of typical lesions in more than one organ system and exclusion of other disorder known to cause granulomatous inflammation. We present the case of a young woman with abdominal pain and weight loss. The finding of splenomegaly by abdominal ultrasound and the presence of hypercalciuria, hypercalcemia and mild renal impairment led us to include sarcoidosis in the differential diagnosis. The final diagnosis was established by demonstration of involvement of lymph nodes and lung parenchyma on CT scan, and typical histology in bioptic specimens collected from bronchial mucosa.

Ultrasonographic Studies in the Management of Recurrent Abdominal Pain

PEDIATRICS ◽  
1990 ◽  
Vol 86 (1) ◽  
pp. 35-38
Author(s):  
Amir Shanon ◽  
David John Martin ◽  
William Feldman
Keyword(s):  
Abdominal Pain ◽  
Children And Adolescents ◽  
Medical Records ◽  
Recurrent Abdominal Pain ◽  
Abdominal Ultrasonography ◽  
Abnormal Finding

The medical records of 65 children and adolescents who had abdominal ultrasonography for the evaluation of recurrent abdominal pain were reviewed. Fifty-three subjects (81%) had normal results; in 12 cases (19%) an abnormality was detected. In no case could the pain be attributed to the abnormal finding. Furthermore, in 3 subjects, disclosure of the abnormal findings could have caused more harm than good. The role of the abdominal ultrasonographic study in the management of recurrent abdominal pain in children and adolescents is discussed.

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