ABSTRACT
OBJECTIVES: symptoms in renovascular hypertension can be wrong interpreted, which leads to a late diagnostic, after discover the determination disease. MATERIALS AND METHODS: the study on the renovascular hypertension was made on 20 patients, aged between 2 and 36 years old, diagnosed with reno-ureteral malformations, pyelonephritis, reno-ureteral reflux and renal trauma as a determination disease, leads to manifestation types that guide the diagnostic: neuro-psychiatric signs, weight loss, renal signs and digestive signs. Beginning from these signs the arterial hypertension was diagnosed and the investigations determined the causes. RESULTS: Periodic postoperative evaluation at 3 months, during a period between 4 months and 7 years, individualised 4 evolutional clinical types: AHT with lumbar pain, AHT with no clinical signs, AHT with ophthalmologic signs and AHT with encephalitis like signs. CONCLUSIONS: symptoms in renovascular hypertension don't have pathognomonic clues and the identified signs, one type or all together, enforce the evaluation or even the monitoring of the arterial tension at least 30 days. If the values exceed the normal, complex investigations will be made in order to determine the specific cause of the AHT.
Subject(s)
Hypertension, Renovascular/complications , Hypertension, Renovascular/diagnosis , Abdominal Pain/etiology , Adolescent , Adult , Back Pain/etiology , Blood Pressure Monitoring, Ambulatory , Child , Child, Preschool , Female , Headache Disorders/etiology , Humans , Hypertension, Renovascular/etiology , Hypertension, Renovascular/therapy , Kidney/abnormalities , Male , Pyelonephritis/complications , Scotoma/etiology , Ureter/abnormalities , Urination Disorders/etiology , Vertigo/etiology , Vesico-Ureteral Reflux/complications , Vision Disorders/etiology , Vomiting/etiology , Weight LossABSTRACT
The researches performed during the last four decades did not elucidate completely the pathogenic mechanism of the renovascular hypertension. The present knowledge considers that the origins of renovascular hypertension are the imbalance between the renal hypotensive system located in the medullar renal site (antihypertensive and hypotensive substances) and the renal hypertensive system (renin-angiotensin-aldosterone) located cortically. As an additional mechanism in producing hypertension is involved the disorder of hydro electrolytic metabolism, as a result of decreased excretory function, inducing an increase of plasmatic natrium level, of volemia and interstitial liquid.
Subject(s)
Hypertension, Renovascular/diagnosis , Hypertension, Renovascular/physiopathology , Kidney/abnormalities , Adult , Child , Child, Preschool , Female , Humans , Hypertension, Renovascular/surgery , Male , Nephrolithiasis/complications , Nephrolithiasis/diagnosis , Nephrolithiasis/surgery , Treatment Outcome , Urinary Tract/abnormalities , Urinary Tract Infections/diagnosis , Urinary Tract Infections/microbiology , Urinary Tract Infections/surgeryABSTRACT
This is a clinical approach regarding 43 resection of intestine, performed in emergency condition, terminated as enterostomy, with represent 20% of enterectomyes performed in emergency condition and 1.6% of urgent operations. The decision of enterostomy has been taken in the conditions of peritoneal sepsis, occlusion or the association of the two circumstances. The results are comparatively analyzed between the cases with enterostomy that has been made from the beginning (66% success, 33% gone wrong), and those with enterostomy made at the second intervention (14% success, 86% gone wrong). One discusses problems of leading, technique and post-operating nursing. The intestinal reintegration has been made possible at 16 patients after a timing of three of four weeks.
