RESUMO
Background and Objective: In patients with unilateral or bilateral loss with high length [More than 10cm] and with different etiologies, ileal substitution is good alternative when other procedures are not suitable. The objective of this study was to survey the effects and complications of ileal substitution for ureteral loss
Cases: Sixteen patients were operated in urologic ward of Shahid Labbafinejad hospital with ileal substitution for ureteral loss during 1994-1999. Twelve patients were male and four were female with mean age 28 years [3-47 years]. Etiology was complications of surgery and ureteroscopy in 11 and TB in 2 and ureteral avulsion in one due to trauma. Follow up was 9-60 months and 3 patients missed follow up. Pre.op sonography, IVP and DTPA isotope scan in all patients revealed severe hydronephrosis in 11 patients. Post.op sonography and scan showed much improvement of kidney function. In 2 patients, hydronephrosis persisted that nephrectomy was performed
Conclusion: In cases with high ureteral loss, which other procedures like uretero-ureterostomy or transuretero-ureterostomy or autotransplant or kidney descending or Boari-Flap cannot be done, ileal substitution is good alternative with low complication
RESUMO
Background and Objective: Less than 1% of pheochromocytoma account for hypertensive vascular diseases. The goal of this report is early diagnosis of this tumor since it is surgically treatable and preventive for lethal complication. In this study, two cases of patients with hypertension due to adrenal pheochromocytoma who were treated by surgical adrenalectomy were reported
Cases: The first patient was a 45-year-old female who presented with hypertension, headache, abdominal pain, sweating weight loss and diabetic mellitus. An 8×6 cm[2] mass was reported in her left adrenal by CT scan. She was operated adrenalectomy. She immediately got a normal blood pressure and controlled diabetic mellitus. The second patient was a 61-year-old male who presented with hypertension and elevated level of 24-hour urinary catecholamine. He was surgically treated by adrenalectomy of right adrenal pheochromocytoma after a 7×6 cm[2] mass was detected on CT scan in his right adrenal as the same of first patient, he got a normal blood pressure and controlled diabetic mellitus immediately after operation
Conclusion: Although pheochromocytoma is a rare cause of elevation of arterial pressure it should be always considered as a cause of elevation of blood pressure. So after the diagnosis it was recommended administration of phenoxybenzamine as an irreversible ? blocker, to prevent hypertensive crisis and cardiac arrhythmia, and for symptom relief of the patients before, during and after the operation, respectively