Spontaneous Rupture Of Kidney Research Articles

Minimally invasive procedures for urological disorders in pregnant patients: our experience

Background: Urological disorders like stone disease, pyonephrosis secondary to obstruction and trauma are common during pregnancy with global incidence of 1 in 250 to 1 in 3000. These diseases can complicate any pregnancy and timely diagnosis and management is of utmost importance for safety of the mother and fetus. Managing these cases entails morbidity and minimally invasive procedures avoiding anesthesia have definite advantage.Methods: It was an observational study. Pregnant patients with nephrolithiasis, pyonephrosis, complicated post-traumatic ureteropelvic junction (PUJ) obstruction (PUJO) and trauma were included in the study.Results: Out of total 84 cases, 45 required intervention. Percutaneous nephrostomy (PCN) for pyonephrosis secondary to PUJO and obstructed PUJ calculus was done in 11 and 14 cases respectively. Bilateral PCN for bilateral nephrolithiasis was done in 7 cases. Silicon double-J stenting for ureteric calculus was done in 13 cases. One case of spontaneous fornicial rupture of kidney without stone disease was managed conservatively as were 4 cases of trauma with concomitant renal injury, 18 cases of non-obstructive renal stones and 16 cases of pyelonephritis. Seven patients lost follow-up. One case each of pyonephrosis and polytrauma had fetal death at term unrelated to urological cause. In rest 75 patients, primary pathology was tackled after 6-8 weeks of delivery.Conclusions: Urological diseases during pregnancy are not an uncommon entity and can pose risk to both mother and fetus. With good clinical vigil, use of minimally invasive procedures, close monitoring and follow up, these patients can be safely managed without any adverse events to the fetus and mother.

Temporary Renal Artery Clamping With Hemostatic Materials in Diffuse Type of Spontaneous Renal Allograft Rupture: A Case Report

BackgroundSeveral surgical strategies have been introduced for spontaneous kidney rupture. Herein, we report on a case in which temporary artery clamping with hemostatic materials was performed. Case PresentationA 52-year-old man underwent renal transplant from a living donor (his 20-year-old son). Spontaneous allograft rupture occurred 6 days after transplant. He developed severe abdominal pain, hypotension, and mental changes. His blood hemoglobin level was 3.6 g/dL, which was indicative of severe hemorrhage. Immediate re-exploration revealed a large hematoma in the iliac fossa and that the renal allograft had ruptured, with multiple fracture lines on the entire surface. Because of diffuse surface rupture, surgical suture was not attempted. For manual compressive hemostasis, temporary artery clamping with hemostatic materials was performed. First, we identified the graft artery for temporary clamping, similar to the method in partial nephrectomy. Second, at the time of temporary clamping, the hemostatic matrix was sprayed on the surface of the renal graft. Third, we compressed the whole renal parenchyma with both hands and a dry pad for 5 minutes. After removing the clamp, successful bleeding control was confirmed. Finally, the graft was wrapped with oxidized cellulose. Renal biopsy in the operating room revealed the cause of rupture as acute rejection type IIB. ConclusionSpontaneous renal allograft rupture is a rare but serious complication. When surgical suture is not appropriate for the repair of the ruptured allograft, temporary artery clamping with hemostatic materials can be considered an alternative.

The use of contrast-enhanced ultrasonography for the detection of active renal hemorrhage in a dog with spontaneous kidney rupture resulting in hemoperitoneum.

To describe the use of contrast-enhanced ultrasonography (CEUS) for the detection of active renal hemorrhage in a dog with spontaneous kidney rupture resulting in hemoperitoneum. A 9-month-old, sexually intact male Boxer dog presented for acute collapse, abdominal pain, and tachycardia. Physical examination findings were consistent with hypovolemia and acute abdomen. B-mode ultrasonography revealed peritoneal effusion and a right kidney mass. Subsequently, a CEUS study was performed on the right kidney, which demonstrated active hemorrhage from that kidney resulting in both hemoretroperitoneum and hemoperitoneum. At exploratory surgery, ultrasonographic findings were confirmed and a right nephrectomy was performed. Histopathology demonstrated severe parenchymal alterations along with the presence of nematode larvae. Fecal and urine testing for the presence of parasitic ova were negative. Identification of the larvae was inconclusive. At 30 days postoperatively, repeat B-mode ultrasound and clinicopathologic testing was unremarkable. The dog was alive at 1 year postsurgery with no ill effects. To the authors' knowledge, this is the first report of CEUS for the detection of active hemorrhage from a kidney resulting in hemoretroperitoneum and hemoperitoneum in a dog. Although rare, the finding of nematode larvae within the renal parenchyma may have been the cause of kidney rupture. Importantly, surgical removal of the kidney was curative. Benign processes causing kidney rupture such as parasitic infestation should be considered in the working diagnosis as related to geographical location.

An invasive mole with bilateral kidney metastases: A case report.

Clinical reports of kidney metastases derived from an invasive mole (IM) are rare. The present study presents the case of a 42-year-old woman who exhibited IM and bilateral kidneys metastases in what may be, to the best of our knowledge, the first report of such a case. Following an induced abortion, the patient initially experienced irregular vaginal bleeding and subsequently presented with left-sided waist and abdominal pain. The patient was admitted to hospital and was clinically diagnosed with gestational trophoblastic neoplasia (GTN), as well as bilateral kidney metastases and a spontaneous rupture of the left kidney. This diagnosis was based on the patient's medical history, which comprised increased levels of human chorionic gonadotropin β and aberrant results on computed tomography (CT) scans. The patient subsequently received conservative management to prevent renal damage, and a standard etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine chemotherapy regimen for GTN was administered. Following eight cycles of chemotherapy, a follow-up CT examination indicated that the damage in the patient's left kidney could not be corrected with conservative treatments, therefore the left kidney was excised and a laparoscopic hysterectomy was performed. The pathological results were consistent with the clinical diagnosis and allowed further classification of the primary tumor as an IM. The present case demonstrated that it is possible for IM to metastasize to the kidney, and furthermore, that this type of metastatic tumor may be fragile and possess the potential to cause spontaneous kidney rupture.

Xanthogranulomatous Pyelonephritis Presented with Spontaneous Kidney Rupture in a Young Woman

Xanthogranulomatous pyelonephritis (XGP) is an uncommon and aggressive form of inflammation of the renal parenchyma particularly resulting in diffuse renal destruction. A previously healthy 25-year-old woman was admitted to our clinic with right flank pain of sudden onset, nausea and high fever. Computed tomography revealed a mass (12 x 7 cm in diameter) around the right kidney with extension to pelvis and paravertebral space. Flank incision was made urgently and a very large perirenal haematoma and abscess formation were found caused by the rupture located at the posterior side of the right kidney. A right nephrectomy was performed and abscess material was evacuated from the perirenal area. XGP was diagnosed by histopathologic examination of the resected kidney. Although XGP regularly demonstrates a gradual progression and presents with nonspecific symptoms, the situation may appear with complications as in our case. Our patient presented with renal rupture and perirenal abscess extending to the pelvis and paravertebral space. To the best of our knowledge, this is the first report of XGP presenting with spontaneous renal rupture in the English literature.

Spontaneous kidney rupture in a patient on chronic hemodialysis

■■ Non-traumatic spontaneous rupture of the kidney in subjects on chronic hemodialysis is a rare event. In most cases it is associated with acquired cystic kidney disease (ACKD) [1] or the presence of kidney cancer. [2] There are few reports on this topic. Until 2009 Goto identified in the Japanese literature only five reports of renal cell carcinoma in patients with end-stage renal disease (ESRD) manifesting with spontaneous rupture. [3] In the general population primary neoplasms of the renal pelvis are uncommon and most are malignant. The majority of these cases consist of transitional cell carcinoma. Squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the renal pelvis are highly uncommon tumors and constitute less than 1% of upper urinary tract neoplasms. [4] SCC and AC are known to be associated with chronic renal calculi and infection. The incidence of coexisting urinary stone disease varies from 18% in the United States to 100% in Hong Kong. [5,6] The

Metastatic gestational trophoblastic tumor presenting as spontaneous kidney rupture: Treatment with embolization

Choriocarcinoma is a rapidly growing tumor that characteristically outgrows its blood supply. We report a rare case of metastatic choriocarcinoma presenting with acute right flank pain due to kidney rupture secondary to renal metastasis. The renal metastasis was embolised to stanch blood for control of hemorrhage. A brief review of the imaging features and therapeutic options for the ruptured renal metastases is discussed along with the case.

215: Spontaneous Kidney Rupture in Pregnancy Due to Cocaine Intoxication

215: Spontaneous Kidney Rupture in Pregnancy Due to Cocaine Intoxication

Spontaneous Kidney Rupture With Incidental Renal Cell Cancer in Patient With Castleman's Disease

A 65-year-old man with a history of Castleman's disease presented with abdominal and right flank pain. He denied any recent trauma. On admission, his hemoglobin was 7.0 g/dL, and the blood urea nitrogen and serum creatinine concentration was 30 and 1.62 mg/dL, respectively. Computed tomography of the patient's abdomen revealed a large right perinephric hematoma. The patient underwent emergency nephrectomy. Microscopic examination of the specimen revealed an incidental renal cell carcinoma.

Spontaneous Rupture of Native Kidney in a Patient Receiving Kidney Transplantation - A case report -

Spontaneous rupture of a kidney can occur as a complication of an acquired cystic kidney lesion. Herein, one case of a spontaneous rupture of a contralateral native kidney, due to the rupture of a cystic lesion during kidney transplantation surgery, is described. The patient was a 24 year old female admitted for left kidney transplantation due to chronic renal failure. During the operation, her arterial blood pressure and central venous pressure gradually decreased after anastomosis of the renal vessel, but without significant bleeding in the operative field or any suspected cause of the decreasing arterial blood pressure. On the first postoperative day, she underwent an abdominal CT, where a retroperitoneal hematoma was found. Therefore, a right nephrectomy was performed. She also had a right perirenal hematoma due to the rupture of cystic lesion in the native kidney. While a spontaneous rupture of the kidney is very rare, especially during the perioperative period, it is important to consider this complication when evaluating the corresponding clinical picture.

Renal Angiomyolipoma Partially Containing Epithelioid Component

Han Min Kim, Joon Myoung Park, Seung Wan Yang, Young Ho In, Min Gyun Kim, Won Jae Yang, Luck Hee Sung, Jae Yong Chung, Hyun-Jung Kim, Soo Hyun Kim From the Departments of Urology, Pathology and Diagnostic Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea Epithelioid renal angiomyolipoma is a recently recognized pathologic variant of angiomyolipoma, which represents a more malignant course than a classical renal angiomyolipoma. We report a case of histologically proven renal angiomyolipoma. The patient presented with the symptoms and signs of spontaneous rupture of the kidney. On surgical exploration, the ruptured kidney with upper pole kidney mass was resected. The enlarged regional lymph nodes were also removed, which showed the same pathology. (Korean J Urol 2007;48:655-658) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Spontaneous kidney rupture--an unusual complication of Wegener's granulomatosis

Spontaneous kidney rupture--an unusual complication of Wegener's granulomatosis

Spontaneous Rupture of the Kidney

The rupture of the kidney with the formation of an extracapsular hematoma in the renal cavity but no evidence of external trauma or other obvious renal cause, is an uncommon finding, most often requiring urgent surgery. An underlying renal pathology, often a renal tumor, should always be suspected. This article describes the case of a 57-year-old male patient who was admitted for severe left flank pain and presented with signs of peritonism, microscopic hematuria and low hemoglobin levels; an emergency left subcostal laparotomy was performed, with removal of the hematoma and enucleation of a partially open mid-renal mass; the kidney was spared. Histology showed a WHO type I, Fuhrman grade 2, papillary renal cell carcinoma. The article deals further with frequency, presentation, type and treatment of the pathology underlying the spontaneous rupture of the kidney, particularly with regard to renal carcinoma.

Spontaneous Rupture of the Kidney due to Genitourinary Tuberculosis

Spontaneous rupture of the kidney is a rare condition generally associated with underlying diseases, and most cases are due to renal tumors. Spontaneous rupture of the kidney with a huge urinoma was found in a 26-year-old man with genitourinary tuberculosis during anti-tuberculosis chemotherapy. The patient was successfully treated with percutaneous drainage, which saves the patient from having a radical operation. Subsequent endoureterotomy with balloon dilatation effectively treated stenosis of the ureter. To our knowledge, this is the first case of kidney rupture as the consequence of genitourinary tuberculosis.

Etiology Of Spontaneous Perirenal Hemorrhage: A Meta-Analysis

Etiology Of Spontaneous Perirenal Hemorrhage: A Meta-Analysis

Spontaneous Kidney Rupture Symptom of Renal Tumors

Spontaneous ruptures of the kidney frequently require an emergency surgical intervention and the underlying pathology often only becomes clear intraoperatively. On the basis of our own cases the clinical management of the symptom 'rupture of the kidney' is discussed particularly referring to renal tumors.

Spontaneous Rupture of Hydronephrotic Kidney during Pregnancy

Rupture of the urinary tract during pregnancy is uncommon. Pyelonephritis, painful overdistension and rupture are occasional effects of pregnancy on the urinary tract. We present a case of spontaneous rupture of a hydronephrotic kidney in a pregnant woman.

Chronic Renal Failure for Bilateral Spontaneous Kidney Rupture in a Case of Tuberous Sclerosis

A case of spontaneous, but not contemporary rupture of both kidneys in a 42-year-old man with tuberous sclerosis is described. Despite the high incidence of renal involvement, chronic renal failure due to replacement and compression of renal tissue by hamartomas is rare. We reviewed 25 cases in the literature and found only 1 other case which necessitated maintenance hemodialytic treatment for kidney rupture. It is suggested that early diagnosis and conservative partial nephrectomy could prevent or delay the onset of chronic renal failure, malignant transformation and dramatic rupture of hamartomas.

Spontaneous Rupture of the Kidney: Case Report and Review of the Literature

Spontaneous Rupture of the Kidney: Case Report and Review of the Literature

Spontaneous rupture of kidney Associated with renal papillary necrosis

Two cases are presented in which rupture of the kidney was associated with ureteral obstruction from a sloughed papilla secondary to papillary necrosis. In one case papillary necrosis was associated with phenacetin ingestion and a relatively benign course. In the other instance there was a fulminating course in which papillary necrosis was associated with diabetes mellitus. Ureteral obstruction from papillary necrosis requires prompt intervention, the delay of which may lead to renal rupture and extravasation of blood and urine with its inevitable consequences.