ABSTRACT
Idiopathic ureteropelvic junction stricture is not an uncommon disorder with resultant hydronephrosis of affecting kidney, and most frequently encountered in infant and children. Multiple causes of stricture have been identified. Abnormal organization of smooth muscle bundles at the ureteropelvic junction has been reported, and electron microscopy has demonstrated excessive collagen deposition within the intramural stroma. However, the exact cause of obstruction of UPJ stricture is uncertain. We reviewed 23 cases with idiopathic hydronephrosis underwent dismembered pyeloplasty. Examination of strictured segment with light the normal interwoven pattern, were arranged into an abundant outer circular and an inner longitudinal layer in 21 of 23 cases. But muscle thickness was not changed, and collagen was normal in both amount and arrangement. This results suggested that the abnormal muscle arrangement at the ureteropelvic junction might be the cause of the idiopathic stricture.
Subject(s)
Child , Humans , Infant , Collagen , Constriction, Pathologic , Hydronephrosis , Kidney , Microscopy, Electron , Muscle, SmoothABSTRACT
Ureteropelvic junction obstruction is one of the most common problems requiring surgical correction in children. Glomerular development, which continues at birth, may interfered with by obstruction. So the recognition and correction of ureteropelvic Junction obstruction at this early age are important. Fortunately, to date, the widespread use of maternal ultrasound has led to an increase in the detection of fetal obstructive uropathy. The operative technique varied according to the nature and severity of the abnormality, but the dismembered pyeloplasty that resect the adynamic segment completely is favored and very successful. We reported 17 cases underwent dismembered pyeloplasty in children due to severe hydronephrosis (over Grade IV) secondary to UPJ stricture, and obtained satisfactory results. Nephrostomy drainage of the kidney was used in l3 cases, and duration was within 2 weeks in most cases. Ureteral stent was used only in 4 cases associated with severe infection or repeated pyeloplasty. In 13 cases followed up over 3 months (Mean: 16 months), the good result was in 11 cases (84.6%) and fair in 2 cases(l5.4%).
Subject(s)
Child , Humans , Constriction, Pathologic , Drainage , Hydronephrosis , Kidney , Parturition , Stents , Ultrasonography , UreterABSTRACT
Bilateral renal cell carcinoma is very rare and represents a challenge to the clinician. In the past, bilateral renal cell carcinoma indicated a poor prognosis. But recent, aggressive operative intervention with 'nephron-salvaging procedure' can improve the survival of bilateral renal cell carcinoma. We experienced two cases of bilateral renal cell carcinoma; the former was multicystic nature, well-differentiated bilateral renal cell carcinoma and the later was found incidentally during cadaver donor transplantation due to brain tumor, and it was documented Von-Hippel-Lindau`s syndrome on autopsy.
Subject(s)
Humans , Autopsy , Brain Neoplasms , Cadaver , Carcinoma, Renal Cell , Prognosis , Tissue DonorsABSTRACT
Emphysematous pyelonephritis is a rare, life-endangering suppurative infection of the renal parenchyma and perirenal tissues. The disease is encountered mainly in the diabetic patient with or without ureteral obstruction and is characterized by the production of intrarenal and occasionally, perirenal gas. We report a case of emphysematous pyelonephritis, treated by left nephrectomy, in 55-year-old diabetic woman.