ABSTRACT
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Subject(s)
Humans , Female , Middle Aged , Arnold-Chiari Malformation/etiology , Neurofibromatosis 1/complications , Magnetic Resonance Spectroscopy , Mass ScreeningABSTRACT
El riñón en herradura es una malformación congénita que predispone al desarrollo de infecciones urinarias altas, por la ectasia piélica inherente a la malrotación de las unidades renales.La nefritis bacteriana aguda es un estadio evolutivo de la infección renal aguda situado entre la pielonefritis aguda y el absceso renal. El diagnóstico diferencial entre estas entidades sólo es posible mediante el apoyo de alguna técnica de imagen, ya que desde el punto de vista clínico son indistinguibles. El TAC con contraste es la técnica de mayor sensibilidad y especificidad en el diagnóstico de nefritis bacteriana aguda, y se considera la prueba de elección. Los hallazgos característicos del TAC son áreas corticales redondeadas o cuneiformes que adquieren una apariencia estriada tras la administración de contraste. El tratamiento está basado en antibioterapia de amplio espectro, que debe mantenerse durante un período de 3-6 semanas.Presentamos un caso de nefritis bacteriana aguda difusa, en un paciente pediátrico con riñón en herradura, que se resolvió satisfactoriamente con tratamiento antibiótico prolongado (AU)
Subject(s)
Adolescent , Male , Humans , Nephritis , Acute Disease , Kidney , Escherichia coli InfectionsABSTRACT
Horseshoe kidney is a congenital malformation which predisposes the patient to severe urinary tract infections, due to pelvic ectasia which is inherent in the malrotation of the renal units. Acute bacterial nephritis is an evolutionary stage of the acute renal infection situated between acute pyelonephritis and renal abscess. It is only possible to carry out a differential diagnosis of these two bodies through the application of some imaging technique, as it is impossible to differentiate them from a clinical point of view. A CT contrast scan is the most sensitive and specific means of diagnosing acute bacterial nephritis, and is considered to be the most appropriate test method. The CT scan usually reveals circular or wedge-shaped cortical areas which become striated after contrast administration. Treatment is based on broad-spectrum antibiotherapy, which must be continued for a period of 3 to 6 weeks. We present a case of diffuse acute bacterial nephritis, occurring in a paediatric patient with a horseshoe kidney, which was successfully treated by means of a prolonged course of antibiotics.
Subject(s)
Escherichia coli Infections/complications , Kidney/abnormalities , Nephritis/complications , Acute Disease , Adolescent , Escherichia coli Infections/drug therapy , Humans , Male , Nephritis/drug therapy , Nephritis/microbiologyABSTRACT
We discuss a case of a 68 years old man with an acute myocardial infarction and a cardiopulmonary arrest that 3 days after his admission developed a continuous abdominal pain and findings of peritoneal inflammation. The mesenteric angiographical study was normal. A laparotomy was practised and disclosed a local peritonitis and a colonic infarction without mesenteric vascular occlusion. This picture is very unusual in patients with acute myocardial infarction or cardiopulmonary arrest.
Subject(s)
Colitis, Ischemic/etiology , Myocardial Infarction/complications , Abdominal Pain/etiology , Aged , Colitis, Ischemic/diagnosis , Colon/blood supply , Humans , Infarction/diagnosis , Infarction/etiology , MaleABSTRACT
Se presenta el caso de un paciente de 68 años que sufrió un infarto agudo de miocardio con parada cardiaca reanimada y que al 3º día de su ingreso desarrolló un cuadro de abdomen agudo y rectorragia. Se realizó angiografía mesentérica que fue normal. Fue intervenido quirúrgicamente evidenciándose peritonitis local y una necrosis en colon ascendente secundaria a una colitis isquémica de origen no oclusivo, cuadro clínico extremadamente infrecuente en este tipo de pacientes (AU)
Subject(s)
Aged , Male , Humans , Abdominal Pain/etiology , Colitis, Ischemic/diagnosis , Colon/blood supply , Infarction/diagnosis , Infarction/etiology , Myocardial Infarction , Colitis, Ischemic/etiology , Myocardial Infarction/complicationsABSTRACT
Bilateral suprarenal haemorrhage (BSH) has not been often described as a cause of chronic suprarenal insufficiency. The diagnosis before death is difficult and it was rare until the CAT scan became a routine diagnostic tool. Of 25 cases reported since 1981, 23 were diagnosed by CAT scan. We report a case of a patient that developed bilateral suprarenal haemorrhage (BSH) during heparin therapy for pulmonary embolism. The early clinical picture resembled a septic shock, and the diagnosis of Addison disease was made later. We reviewed the medical literature and we emphasized the clinical problems in which we should suspect the diagnosis of BSH, where early therapy with steroids may be critical to save the patient's life.
