ABSTRACT
Tiaprofenic acid is a non-steroidal anti-inflammatory drug that may cause severe non-bacterial cystitis. Three cases are described and the literature is reviewed.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cystitis/chemically induced , Propionates/adverse effects , Aged , Cystitis/pathology , Female , Humans , Male , Middle Aged , Urinary Bladder/pathologyABSTRACT
Eighty-four patients with solitary calyceal stones were treated with Extracorporeal Shock Wave Lithotripsy (ESWL) as first line monotherapy. The indications for treatment were pain in 51 patients (61%), infection in 11 patients (13%), pain and infection in 18 patients (21%) and others in 4 patients (5%). Stone size (largest diameter) was median 9 mm (range 2-25 mm). Follow-up consisted of clinical control, isotope renography and a plain film after 1 month; hereafter plain films after 3 and 6 months. Auxiliary procedures due to steinstrasse were performed in 3 out of 4 patients (1 nephrostomy, 1 nephrostomy + ESWL of ureteral fragments, and 1 ureteroscopic manipulation). Retreatment of the calyceal stone was performed in 3 patients within 6 months (2 re-ESWL, 1 lower pole resection). Stone-free (without retreatment or auxiliary procedures) were 26/84 (31%) after 1 month, 34/84 (40%) after 3 months and 38/84 (45%) after 6 months. Free of pain were 43/69 (62%) after 1 month, 50/69 (72%) after 3 months and 59/69 (86%) after 6 months. Free of infection were 18/29 (62%) after 1 month, 19/29 (66%) after 3 months and 21/29 (72%) after 6 months. Complications included steinstrasse in 4 patients, sepsis in 3 patients, displacement of JJ-stent in 2 patients and atrio-ventricular dissociation in 1 patient. To conclude: ESWL as first line therapy for solitary calyceal calculi offers good results with regard to pain and clearance of infection, but leaves 55% with residual stone material.
Subject(s)
Kidney Calculi/therapy , Lithotripsy , Adult , Aged , Aged, 80 and over , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Kidney Calculi/diagnostic imaging , Kidney Calices/diagnostic imaging , Male , Middle Aged , Nephrostomy, Percutaneous , Radiography , Recurrence , Retreatment , Treatment OutcomeABSTRACT
Five cases of spontaneous rectus sheath haematomas observed during one year are reported. The female to male ratio was four to one. The age range was 26-75 years. Precipitating factors were cough in three patients, physical exercise in one patient, and none in one patient. In three cases there were possible predisposing factors: anticoagulant therapy, Addison's disease with steroid treatment and abdominal scar. The localisations were three lower right quadrant, one lower left and one upper right. In three cases correct diagnoses were made based on clinical findings, confirmed by ultrasonography and treated conservatively. In two cases the diagnosis was not suspected clinically, and by ultrasonography the haematoma was overlooked in one case, and misinterpreted as an intraperitoneal tumour in the other; both cases underwent surgery. The incidence rate was estimated to 3.5 per 100,000 per year. The frequency was approximately 0.9% in patients admitted with "acute abdomen".
Subject(s)
Gastrointestinal Hemorrhage , Hematoma , Rectal Diseases , Adult , Aged , Female , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/surgery , Hematoma/diagnosis , Hematoma/etiology , Hematoma/surgery , Humans , Male , Middle Aged , Rectal Diseases/diagnosis , Rectal Diseases/etiology , Rectal Diseases/surgery , Rectum/blood supply , Retrospective StudiesABSTRACT
A case of benign pneumoperitoneum and subcutaneous emphysema of the scrotum after elective colonoscopy with polypectomy is reported. The development and treatment of benign pneumoperitoneum is discussed.
Subject(s)
Colonoscopy/adverse effects , Pneumoperitoneum/etiology , Scrotum , Subcutaneous Emphysema/etiology , Aged , Humans , Male , Pneumoperitoneum/diagnosis , Pneumoperitoneum/therapy , Scrotum/pathology , Subcutaneous Emphysema/diagnosis , Subcutaneous Emphysema/therapyABSTRACT
The plasma urea:creatinine ratio (U:C ratio) is known to be elevated in cases of upper gastrointestinal bleeding. Almost all patients with haematemesis have upper gastrointestinal (or generalized) bleeding so that in this study we characterized the diagnostic power of the U:C ratio in patients with stools containing altered blood without haematemesis in the hope that this simple laboratory test (used in conjunction, perhaps, with clinical data) might reduce the number of patients subjected to an unrewarding gastroscopy or colonoscopy. Of 76 cases seen in a provincial and a metropolitan hospital, 42 and 34 patients had upper and lower gastrointestinal bleeding, respectively. Fifty-four per cent of those with upper gastrointestinal bleeding and none of those with lower gastrointestinal bleeding had U:C ratios above 110 on admission. However, a discriminating level of 90 is considered to be more suitable, judged by the quadratic uncertainty score. At this level the odds for upper gastrointestinal bleeding were 15:1.
Subject(s)
Creatinine/blood , Gastrointestinal Hemorrhage/diagnosis , Occult Blood , Urea/blood , Aged , Aged, 80 and over , Colonic Diseases/complications , Colonic Diseases/diagnosis , Female , Humans , Male , Middle Aged , Peptic Ulcer Hemorrhage/diagnosis , Predictive Value of TestsABSTRACT
In cases of anal prolapse in infants, intussusception should be considered in the differential diagnosis as the apex of the intussusception may present per annum even in cases with brief histories and no change in the general condition.
Subject(s)
Ileal Diseases/diagnosis , Intussusception/diagnosis , Rectal Prolapse/diagnosis , Diagnosis, Differential , Humans , Infant , MaleABSTRACT
A case of migration of a broken needle from the right femoral vein to the heart leading to severe pericarditis in a heroin addict is described.
