[Emphysematous pyelonephritis].
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Biomedical subjects
Publications and source records attributed to A Ameur.
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Urachal remnants are not exceptional and are symptomatics if complicated. Ultrasound and CT scan identify most diseases entities originating from urachal remnant. Treatment consists on total exeresis because there is a risk of malignant degeneration. The authors report a case of urachal remnant and analysis the anatomopathologic, diagnosis and therapeutic features of urachal remnants in a review of the literature.
Segmental renal hypoplasia or Ask-Upmark kidney is an extremely rare anomaly that induces severe arterial hypertension in young patients. Two new cases of this entity are presented respectively in a 39 and 31 years old women who are admitted for hematuria, elevated blood pressure level and flank pain. Surgical treatment of the hypoplasia kidney permitted successful treatment of the high blood pressure with preservation of renal function and flank pain. In view of the literature, the authors discuss the pathogenic, diagnostic and therapeutic aspects of this condition.
The authors present modified Denis's technique for hemostasis in 20 suprapubic prostatectomy. The technique is based on the separation between the bladder and the prostatic fossa with a temporary purse-string suture around the bladder neck. The vacuum of the prostatic fossa leads to the retraction and hemostatis. This technique is very effective on intra and post operative hemorrhage, so economy of irrigating fluid; then easier post operative care.
Urinary tract involvement in neurofibromatosis type 1 is rare and uncommon entity. The syndrome is transmitted as an autosomal dominant trait and is characterized by cutaneous pigmentation and tumors as neural crest origin. Two cases of kidney involvement by Von rechlinghausen's disease with in one case a consequent hydronephrosis with arterial hypertension and in the second a nephrocalcinos without hyperparathyroidism are present. The literature of urogenital and nephrologic neurofibromatosis is reviewed. The authors suggest that the patient with neurofibromatosis be screened annually with medical history, physical examination, urinalysis and serum chemistry for tumors that affect the urinary particularly in children.
Retroperitoneal sarcoma is a rare solid tumor that accounts for less than 15% of soft tissue sarcoma. The authors conducted a retrospective study about 6 cases to evaluate the natural history of the tumors and the causes of treatment failure in an attempt to develop a rational approach to the management of the neoplasm. The histological grade and complete resection are the most important prognosis factors.
The authors report a series of 13 horseshoe kidneys observed over a 22-year period. All patients are men with a mean age of 39 years (20-65 years). The clinical features were dominated by abdomino-lumbar pain (nine cases). The horseshoe kidney was associated with renal stones in nine cases, uretero-pelvic junction syndrome in five cases and pyonephrosis in one case. The specific anatomic and surgical features of this rare malformation are emphasized and the therapeutic features of each uropathy associated with horseshoe kidney are discussed.
Hemospermia or hematospermia is a common benign condition, but its prevalence remains unknown and can result from several causes. The aetiology is idiopathic in about 30-70% of the cases. The hemospermia is first of inflammatory origin, in the young patients, where it is due to uretroprostatitis or orchi-epididymitis, but in the older, it is due to a benign of malignant prostatic tumors. Transrectal ultrasonography and magnetic resonance imaging can afforded the opportunity to best investigate the patients with hemospermia. Hemospermia is not an uncommon problem and in most instances has little clinical significance other than evoking much anxiety for the patient. In view of the literature, the authors discus the diagnostic and therapeutic approach of hemospermia through a series of seven cases.
A variety of neoplasms derived from mesechymal elements may arise on the tunica dartos, the tunica albuginea or, more rarely, within the testis or the epididymis. The authors report a case of leiomyoma of the scrotum in a 33-year-old man. This rare and benign tumour is localized in the tunica dartos in 8% of cases. The positive diagnosis is based on histological examination after conservative treatment by local excision which gives excellent results.
Supernumerary kidney is a rare poorly documented anomaly. It's generally discovered in stage of complications. Preoperative diagnosis is difficult. The authors report a case of hydronephrotic supernumerary kidney, diagnosed preoperatively, in a 45 years old patient with a review of the literature.
Adult nephroblastoma is a rare tumor. The authors report two new cases observed in a 30 and 34 years old men in whom the diagnosis was made by histo-pathology. They were admitted for enormous kidney mass. We performed nephrectomy in one case, and surgical biopsy in the other. No adjuvant treatment was given. The prognosis was fatal. They study the particular features of this tumour. Its prognosis appeared to be poorer than that of renal adenocarcinoma.
Ovarian vein syndrome corresponds to ureteral compression by a dilated ovarian vein. The pathogeny of this syndrome is discussed. It seems to be multifactorial, comprising an anatomical and hormonal factors. Ovarian vein syndrome is classically described on the right side. Patients present with lumbar pain or renal colic. Diagnosis is mainly urographic. The surgery constitutes radical treatment of the entity. However, this disorder can be successfully treated laparoscopically. Transcatheter embolisation provides excellent result which may replace or complement the traditional surgical approaches of this disease. On the basis of one case and other recent series, the authors review its different aspects, including some considerations on this rarely reorganized and poorly understood disease.
Spontaneous subcapsular haematoma (SCH) of the kidney is a rare condition, secondary to kidney tumors in more than 50% of cases. Diagnosis is suggested by sonography and confirmed by CT-scan. Renal angiography, performed in haemodynamically stable patients, shows the origin of bleeding and allows embolization. The authors report 6 cases of SCH of the kidney, one of which occurred after extra-corporeal shock-wave lithotripsy.
The present study reported two cases of hydatid cysts localized in Douglas space and that broke in the bladder. The clinical course was characterized by urinary symptoms and by presence the cysts in urine. Abdominopelvic ultrasonography is essential for diagnosis and identification of other sites. When diagnosis is unclear, then CT scan plays a role. Therapy included cystectomy and pericystic resection in one case and intravescical injection of H2O2 in the second case. The course was favorable in both cases.
The authors report two cases of renal multilocular cyst and review the cases reported in the literature, revealing the original features of this benign tumour which has an equal incidence in children and adults with a controversial acquired or malformative aetiopathogenesis, precise histological features, but a difficult preoperative and intraoperative diagnosis despite modern imaging techniques. In the great majority of cases, treatment consists in nephrectomy.
We describe the case of a 32 year old man who developed such a stenosis after surgery for traumatic rupture of the corpus cavernosum. The aetiology of this rare complication is also given. The stenosis was well outlined by cystography and responded successfully to conservative treatment.
Paratesticular rhabdomyosarcoma is a rare and highly aggressive tumor. The authors discuss the diagnosis and therapeutic problems raised by this lesion and report three cases with a review of the literature.