ABSTRACT
OBJECTIVE: To report two cases of right crossed non-fused renal ectopia diagnosed in male patients about 30 years of age who arrived to emergency centres with symptoms of renal colic. METHODS: We report two cases of male patients who arrived to an emergency centre complaining of colic lumbar pain. Crossed renal ectopia was finally revealed by means of intravenous urogram after several analytical and imaging examinations. RESULTS/CONCLUSION: Right crossed non-fused renal ectopia is an uncommon congenital anomaly with a higher incidence in males. It is much more common to find a crossed fused renal ectopia of the orthotopic kidney. In contrast, if there is no fusion it may be located on the lower portion of the normal kidney, which is not the case in this instance. This malformation is not usually accompanied by other congenital anomalies. Most of cases are spontaneously solved and they do not require an intercurrent surgical intervention.
Subject(s)
Kidney/abnormalities , Adult , Congenital Abnormalities/diagnosis , Humans , MaleABSTRACT
OBJETIVO: Aportación de dos casos de ectopia renal cruzada derecha sin fusión diagnosticada en pacientes varones de alrededor de 30 años que acuden a urgencias con sintomatología de cólico renal. MÉTODO: Presentamos los caso de dos varones que acuden al servicio de urgencias por dolor en fosa lumbar de tipo cólico. Después de realizar varias pruebas analíticas y de imagen, se descubre finalmente con la urografía intravenosa, una ectopia renal cruzada. RESULTADOS/CONCLUSIÓN: La ectopia renal cruzada derecha sin fusión es una anomalía congénita poco frecuente con una mayor incidencia en hombres. Lo más común es encontrar una ectopia renal cruzada con fusión del riñón ortotópico o en el caso que no haya fusión, que éste se encuentre en posición inferior al riñón normal, a diferencia del caso presentado. Ésta malformación no suele ir acompañada de otras alteraciones congénitas. La mayoría de casos se resuelven espontáneamente y no precisan de tratamiento quirúrgico intercurrente
OBJECTIVE: To report two cases of right crossed non-fused renal ectopia diagnosed in male patients about 30 years of age who arrived to emergency centres with symptoms of renal colic. METHODS: We report two cases of male patients who arrived to an emergency centre complaining of colic lumbar pain. Crossed renal ectopia was finally revealed by means of intravenous urogram after several analytical and imaging examinations. RESULTS/CONCLUSION: Right crossed non-fused renal ectopia is an uncommon congenital anomaly with a higher incidence in males. It is much more common to find a crossed fused renal ectopia of the orthotopic kidney. In contrast, if there is no fusion it may be located on the lower portion of the normal kidney, which is not the case in this instance. This malformation is not usually accompanied by other congenital anomalies. Most of cases are spontaneously solved and they do not require an intercurrent surgical intervention
Subject(s)
Humans , Male , Renal Colic/complications , Renal Colic/diagnosis , Renal Colic/physiopathology , Urography/methods , Urography/standards , Urography , Congenital Abnormalities/diagnosis , Emergency Medicine/methods , Emergency Medicine/trends , Urologic Diseases/congenital , Kidney/abnormalitiesABSTRACT
Non-muscle invasive bladder cancer is one of the most prevalent and incident neoplastic conditions in the Western world. Its clinical management involves significant costs for health systems. Diagnosis and treatment are based on direct visualization of the disease and on detection of flat forms having no specific morphology and which are sometimes overlooked. Prognosis of NMIBC often depends on quality of transurethral resection and on early detection of undifferentiated flat forms. Cystoscopy using photosensitive substances such as 5-aminolevulinic acid (5-ALA) or hexyl aminolevulinic acid (HAL) achieves overdetection rates of 29 % for bladder neogrowths and 59% for carcinoma in situ. This overdetection ability results in an increased disease-free survival and a longer time to the first relapse. Increased costs resulting from use of these resources are compensated by a lower number of or delayed performance of cystectomies, resections, and instrumentations. It is concluded that PDD should be universally used, rather than in high risk patients only.that has been shown in both animal studies and human tumors.
Subject(s)
Aminolevulinic Acid/analogs & derivatives , Carbon Radioisotopes , Photosensitizing Agents , Urinary Bladder Neoplasms/diagnosis , Diagnostic Techniques, Urological , HumansABSTRACT
El cáncer vesical no músculo-invasivo es una de las neoplasias de mayor incidencia y prevalencia en el medio occidental. Su control clínico origina un gasto importante a los sistemas de salud. El diagnóstico y el tratamiento se basan en la visión directa de éste y en la detección de formas planas que no presentan una expresión morfológica característica y que, en ocasiones, pasan inadvertidas. El pronóstico de este proceso depende en muchos casos de la calidad de la resección transuretral y en la detección temprana de formas planas indiferenciadas. La cistoscopia con empleo de sustancias fotosensibilizantes, como el ácido 5- aminolevulínico (5-ALA) o el ácido hexil-amino-levulínico (HAL), consigue tasas de sobre detección de neoformaciones vesicales del 29%, y en el caso concreto del carcinoma in situ, del 59%. Esta capacidad de sobre detección lleva consigo un aumento de supervivencia libre de enfermedad y del tiempo a la primera recidiva, entre otros parámetros analizados. El incremento en el coste al emplear estos recursos se compensa, ya que se disminuye oretrasa en número de cistectomías, el número de resecciones y el de instrumentaciones. Concluimos que debe de universalizarse el empleo de sustancias fotosensibles, no sólo empleándolas en aquellos casos de riesgo alto (AU)
Non-muscle invasive bladder cancer is one of the most prevalent and incident neoplastic conditions in the Western world. Its clinical management involves significant costs for health systems. Diagnosis and treatment are based on direct visualization of the disease and on detection of flat forms having no specific morphology and which are sometimes overlooked. Prognosis of NMIBC often depends on quality of transurethral resection and on early detection of undifferentiated flat forms. Cystoscopy using photosensitive substances such as 5-aminolevulinic acid (5-ALA) or hexylaminolevulinic acid (HAL) achieves over detection rates of 29 % for bladder neogrowths and 59% for carcinoma in situ. This overdetection ability results in an increased disease-free survival and a longer time to the first relapse. Increased costs resulting from use of these resources are compensated by a lower numerof or delayed performance of cystectomies, resections, and instrumentations. It is concluded that PDD should be universally used, rather than in high risk patients only, that has been shown in both animal studies and human tumors (AU)
