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At least 577 records · Page 32Linked to original sources
PubMed2003

Current treatment of gunshot wounds to the hip and pelvis.

Gunshot wounds to the pelvis can result in injuries to various organ systems. These injuries require the care of a multispecialty trauma team at a trauma center. Orthopaedic care includes wound treatment, fracture stabilization, and infection prophylaxis. Wound care is determined by the personality of the injury, and not solely based on the velocity of the missile. Antibiotic treatment usually is indicated for patients with gunshot wounds to the pelvis, but is controversial in patients with low-energy wounds. Fractures are treated based on their stability. Regional consideration of pelvic gunshot wounds includes injuries with associated abdominal viscus injury, intraarticular bullets, and retained bullets in the spinal canal.

Hip Injuries↗
PubMedDate not supplied

Visual survey of cancer dissemination: classic patterns on helical CT. Abdomen and pelvis.

Helical CT evaluation of the abdomen and pelvis can be challenging in the cancer patient. This pictorial essay illustrates the important sites of neoplastic dissemination in the abdomen and pelvis. We will emphasize the classic CT appearance of several selected sites and indicate, where appropriate, the primary lesions usually associated with each.

Abdominal Neoplasms↗
PubMed1992

Venous injuries of the lower extremities and pelvis: repair versus ligation.

Many surgeons advocate repair of venous injuries to prevent the sequelae of venous ligation. Since 1986, we have treated 74 patients with 79 venous injuries of the lower extremity or pelvis. There were 68 men and six women with a mean age of 29.2 years (range, 16-62 years). The mechanisms of injury were gunshot wounds in 61 patients, stab wounds in 11 patients, and shotgun wounds and blunt trauma in one patient each. Forty-eight injuries were treated by ligation; 31 injuries were treated by repair. Repairs included two interposition grafts, eight end-to-end repairs, 16 venorrhaphies, and five vein patches. In addition, we developed a venous injury staging system (VIS), which ranged from grade I (less than 50% laceration) to grade IV (complete interruption with soft-tissue injury). Patient age, mechanism, location of injury, associated injuries, and incidence of arterial injury were not different between the patients treated by ligation and those treated by repair. Patients treated with venous ligation had a greater VIS (mean, 3.45 vs. 2.0), a greater incidence of shock (71% vs. 39%), and higher transfusion requirements (9.23 vs. 4.82 units). Postoperative morbidity rates were identical, however. There was no increase in the need for fasciotomy in patients treated with venous ligation. Eighty-six percent of the patients treated by ligation were totally free of edema at discharge. The others had only mild edema that did not interfere with daily activities at discharge and follow-up. Ligation is a safe alternative to repair in patients with injuries to the lower extremities or pelvis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Acute retroperitoneal hemorrhage due to transitional cell carcinoma of the renal pelvis.

A young, otherwise healthy man was hospitalized with clinical findings of acute retroperitoneal hemorrhage. Radiographic evaluation suggested a large bleeding renal mass that was thought to be renal cell carcinoma. Radical nephrectomy was performed after angio-embolization. Final pathological diagnosis was grade III transitional cell carcinoma of the renal pelvis invading the renal parenchyma. Distal ureterectomy was subsequently performed 12 days after nephrectomy. Preoperative or intraoperative diagnosis of transitional cell carcinoma would have spared our patient the morbidity of a delayed second procedure. Transitional cell carcinoma of the renal pelvis should be considered in the differential diagnosis of acute retroperitoneal hemorrhage.

Acute Disease↗
PubMed1997

Apoptosis in transitional cell carcinoma of the renal pelvis and ureter: association with proliferative activity, bcl-2 expression and prognosis.

PURPOSE: We attempted to clarify the significance of apoptosis in tumor development and progression in 64 cases of transitional cell carcinoma of the renal pelvis and ureter by investigating apoptosis, proliferative activity and bcl-2 expression. MATERIALS AND METHODS: We used in situ deoxyribonucleic acid nick end labeling for apoptotic cells and immunohistochemical staining for bcl-2 on archival tumor material. RESULTS: The apoptotic index correlated significantly with mitotic index, histological grade and pathological stage. There was no significant relationship between apoptotic index and bcl-2 expression. Patients with an apoptotic index greater than or equal to 0.22 had a poor prognosis. CONCLUSIONS: Apoptosis is closely related to proliferative activity, tumor differentiation and depth of invasion in transitional cell carcinoma of the renal pelvis and ureter.

Adult↗
PubMed1989

Diagnosis of thrombosis of the deep veins of the lower extremities and pelvis and pulmonary thromboembolism using 99Tcm human serum albumin macroaggregates.

Radionuclide phlebography of the lower extremities, pelvis and pulmonary scintigraphy was performed using 99Tcm human serum albumin macroaggregates (MAA) in 90 patients aged 20 to 80 years, 13 (14%) in post-operative period and 77 (85%) with suspected deep venous thrombosis or pulmonary thromboembolism. The aim of the study was to evaluate the diagnosis of thrombosis of the deep veins of the lower extremities and pelvis and pulmonary thromboembolism using a refined technique. Deep venous thrombosis (DVT) was detected in all surgical patients and in 59 patients with systemic diseases. Perfusion scintigraphic defects characteristic of pulmonary thromboembolism (PE) were discovered in 12 of the surgical patients and in 38 of the medical patients. The results of the examinations have again shown that patients after surgery are exposed to high risks of DVT and pulmonary thromboembolism, while a relatively high percentage of normal findings in patients with suspected DVT have indicated unreliability of clinical symptoms and signs in diagnosing this disease.

Adolescent↗
PubMed2004

Adjuvant radiotherapy with and without concurrent chemotherapy for locally advanced transitional cell carcinoma of the renal pelvis and ureter.

PURPOSE: Transitional cell carcinoma of the upper urinary tract is a relatively uncommon malignancy. The role of adjuvant radiation therapy and chemotherapy is not well defined. We retrospectively reviewed the records of 31 patients who underwent surgery followed by adjuvant radiotherapy with or without concurrent chemotherapy to determine overall outcome as well as impact of concurrent chemotherapy administration. MATERIALS AND METHODS: Between 1970 and 1997, 31 patients with nonmetastatic transitional cell carcinoma of the upper urinary tract (renal pelvis in 13, ureter in 15, and renal pelvis and ureter in 3) were treated with radiotherapy following attempted curative resection. Most patients (28 of 31) had T3/4 and/or N+ disease. The median radiation dose was 46.9 Gy. Nine patients received methotrexate, cisplatin and vinblastine chemotherapy for 2 to 4 cycles, followed by concurrent cisplatin with radiation. RESULTS: Median followup was 2.6 years in all patients and 8.5 years in survivors. Median survival in all patients was 2.4 years. Of the patients 16 (52%) experienced disease relapse, including 9 (29%) with distant metastases alone. Seven patients (23%) experienced locoregional failure with distant metastases developing in all except 1 within 8 months of locoregional failure diagnosis. Five-year actuarial overall survival, disease specific survival, locoregional control and metastasis-free survival rates were 39%, 52%, 67% and 48%, respectively. On univariate analysis patients had improved 5-year actuarial overall and disease specific survival with the administration of concurrent chemotherapy (27% vs 67%, p = 0.01 and 41% vs 76%, p = 0.06, respectively). CONCLUSIONS: Our series suggests that the addition of concurrent cisplatin to adjuvant radiotherapy improves the ultimate outcome in patients with resected, locally advanced upper tract urothelial malignancies. This regimen should be considered in patients with T3/4 and/or node positive upper tract transitional cell carcinoma.

Actuarial Analysis↗
PubMed2003

Percutaneous osteoplasty as a treatment for painful malignant bone lesions of the pelvis and femur.

The purposes of this report are to describe percutaneous osteoplasty as a highly effective minimally invasive procedure to treat painful malignant bone lesions of the pelvis, ilium, and femur and to discuss the relevant literature. Five patients with histologically proven metastases to the pelvis, ilium, or femur were treated by percutaneous injection of liquid bone cement as an attempt to control severe bone pain. After percutaneous osteoplasty, all five patients experienced immediate and substantial pain relief and did not require pain medication for the duration of follow-up. No clinically significant complications occurred. Whereas percutaneous osteoplasty of the spine (vertebroplasty) is well-described and widely accepted to treat pain caused by benign or malignant vertebral body diseases, osteoplasty of bones outside the spine is less known. The immediate good clinical results observed in our small patient group should encourage more widespread application of this palliative treatment.

Aged↗
PubMed1998

Histology and ultrastructure of the urothelium lining the ureter and the renal pelvis in sows.

The histology and ultrastructure of the urothelium lining the ureter and renal pelvis in sows was examined using light microscopy, and scanning and transmission electron microscopy. The epithelium of both the ureter and the renal pelvis were similar and consisted of the basal, the intermediate and the superficial cells. The luminal surface of the superficial cells was characterized by microplicae. Transmission electron microscopy showed that the luminal membrane of these cells showed trilaminar asymmetric unit membrane. Tight junctions linked the lateral parts of the superficial cells, while the intermediate and the basal cells were connected to each other and the basal cells with the basal membrane through desmosomes and hemidesmosomes, respectively. Clusters of mitochondria were observed throughout the urothelium. Unlike that of the basal cells, the Golgi complex and the endoplasmic reticulum were well developed in the superficial and intermediate cells. Lysosomes and vesicles were observed only in the superficial and the intermediate cells. Fine cytoplasmic filaments, although very few in the basal cells, were observed throughout the epithelium. The results are compared and discussed with the findings reported on the urotherlium of other mammalian species and humans.

Animals↗
PubMed1989

Volume related configurational changes in the aetiology of pelvi-ureteric junction obstruction.

The aetiology of pelivi-ureteric junction (PUJ) obstruction is controversial. We present four patients who had normal or equivocal intravenous pyelograms and non-obstructive Whitaker tests in whom complete pelvi-ureteric obstruction was precipitated by more rapid distension of the renal pelvis. We speculate that in vivo physiological urine flow rates and temporary kinking of PUJ produces a critical increase in pelvic volume and subsequent valvular kinking of the upper ureter, which cannot be usually achieved by maximal urine flow rates alone. Co-existence of vesico-ureteric reflux (VUR) may be a contributory factor to critical pelvic distension and tortuous PUJ. Volume related configurational changes of this type are probably a more frequent cause of PUJ obstruction than is generally recognised.

Child↗
PubMed1997

Radiation dose in computed tomography of the pelvis: comparison of helical and axial scanning.

An anthropomorphic Rando phantom was used to compare radiation doses sustained during helical and conventional axial CT of the pelvis. The values obtained with the Rando phantom were validated against cadaveric phantoms, and show good agreement. For the authors' particular CT unit, helical scanning was found to deliver a lower radiation dose than conventional axial scanning. This was most prominent at 1.0-s tube rotation times (average dose ratio 1.24). For realistic scanning parameters and exposure factors, the ratio of radiation dose to pelvic organs can be expected to lie in the range of 40-100 mGy. The whole-body effective dose (ED) depends on selection of scanning parameters and patients anatomy. In a favourable case scenario, the ED for CT scanning of the pelvis in a male can be expected to be between 10 and 20 mSv if the scrotum is not included in the radiation field, while the ED in a female will be approximately 20 mSv. An examination of scatter radiation fall-off curves from a single slice shows that the spread of scatter radiation is only marginally affected by slice thickness. A total of 10-12 cm of human soft tissue acts as a good barrier against internal scattered radiation. The use of such scatter fall-off curves, together with manufacturers' dosimetry specifications, allows a fast estimate of absorbed dose.

Cadaver↗
PubMed2006

Imaging of vascular disorders of the female pelvis.

Clinical presentation of vascular disorders of female pelvis including placental adhesion, retained product of conception, ovarian venous thrombosis, varices, torsion and haemorrhagic infarct of ovary is often non-specific. Because of its availability, safety, and cost-effectiveness, ultrasound is the first investigation of choice. Computed tomography and MRI clearly depict the pelvic and retroperitoneal anatomy. This pictorial essay illustrates the complementary role of US, CT, and MRI in diagnosing vascular disorders of female pelvis.

Adult↗
PubMed1988

Unusual renal pelvic tumor containing transitional cell carcinoma, adenocarcinoma and sarcomatoid elements (so-called sarcomatoid carcinoma of the renal pelvis). A case report and review of the literature.

A case of sarcomatoid carcinoma of the renal pelvis in a 66-year-old male is reported. The patient underwent left nephroureterectomy because of renal pelvic tumor and hydronephrosis. Left renal calcification and atrophy had been diagnosed in the patient about thirty years previously. The tumor showed a polypoid configuration and occupied the renal calyces. Histologically, not only solid nests of transitional cell carcinoma (TCC) and adenocarcinomatous glands but also large spindle-shaped cells with bizarre nuclei simulating sarcoma were identified. Immunoreactive keratin and epithelial-membranous antigen (EMA) were demonstrated in the sarcomatoid cells, indicating that they were of epithelial origin. So far, only 10 cases of so-called sarcomatoid carcinoma or carcinosarcoma of the renal pelvis have been reported in the world. In this report, we summarize the pathological findings of previously reported cases and discuss the histogenesis of this rare tumor.

Adenocarcinoma↗
PubMed1997

Transitional cell carcinoma of the renal pelvis with vena caval tumor thrombus.

We report a case of transitional cell carcinoma of the renal pelvis with vena caval tumor thrombus. To our knowledge only 14 cases of transitional cell carcinoma of the renal pelvis protruding into the vena cava have been reported. The literature regarding these cases is reviewed, and the differential diagnosis of this tumor from renal cell carcinoma is discussed.

Carcinoma, Transitional Cell↗
PubMed2004

Case of leiomyosarcoma of the renal pelvis.

A 54-year-old man presented at the Mibayashi clinic with bowel discomfort. Ultrasonography showed a left renal mass and the patient was referred to Noto General Hospital for urological evaluation. Results of the physical examination were unremarkable, but computed tomography and magnetic resonance imaging demonstrated a large tumor in the middle of the left kidney. The patient underwent left nephrectomy. On hemisection of the kidney, a firm tumor, measuring 8 x 7.5 cm, was seen occupying the renal pelvis. The histological diagnosis was leiomyosarcoma arising from the right renal pelvis. No treatment was provided after surgery and no recurrence was observed 6 months postoperatively.

Biopsy, Needle↗
PubMed2004

Squamous cell carcinoma in the renal pelvis of a horseshoe kidney.

We report a rare case of squamous cell carcinoma in the renal pelvis of a horseshoe kidney. An 80-year-old woman was referred to the National Nagano Hospital for the examination of occult blood in her urine. Microscopic hematuria was found, but pyuria was not seen. Computed tomography and magnetic resonance imaging showed a mass in the left renal pelvis of the horseshoe kidney. No renal stone or hydronephrosis was found. Cytopathological examination in the voided urine specimen was positive. Left nephroureterectomy with the splitting of the isthmus of the horseshoe kidney was performed without renal pedicle clamping using a microwave tissue coagulator. No bleeding was encountered after separating the isthmus. A final pathological diagnosis of squamous cell carcinoma with a tumor thrombus was made. Lymph node metastasis had developed and rapidly progressed and the patient died of disseminated malignancy 4 months after the operation. We reviewed 24 cases of renal pelvic tumor in horseshoe kidneys previously reported in Japan. Seven cases (30%) included components of squamous cell carcinoma. The incidence is higher than that of renal pelvic tumors in the general population.

Aged↗
PubMed2005

Granulocyte-colony stimulating factor producing urothelial carcinoma of renal pelvis.

We report a case of granulocyte-colony stimulating factor (G-CSF) producing urothelial carcinoma of the renal pelvis in a 39-year old man. The patient was admitted to Kobe University Hospital, Kobe, Japan, complaining of macrohematuria and a 6-month history of left abdominal swelling. Abdominal computed tomography showed a large mass in the left kidney and para-aortic lymph node enlargement. A remarkable degree of leukocytosis was detected without any acute infectious disease. Enzyme immunoassay of the serum demonstrated a remarkable high concentration of G-CSF. The patient underwent left nephroureterectomy and para-aortic lymphadenectomy. Histochemical examination revealed urothelial carcinoma. Immunohistochemical staining with an anti-G-CSF antibody demonstrated G-CSF secreting cells. The patient died 8 weeks after the surgical operation. To our knowledge, this is the second case of G-CSF producing urothelial carcinoma of renal pelvis reported in the English literature.

Adult↗