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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Renal ultrasound identifies mild right hydronephrosis but no calcified calculi. There are similar findings following an unenhanced CT urinary tract. A contrast enhanced CT urogram is then performed which identifies a few small filling defects in the right renal pelvis.
Applied Surgical Anatomy
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Vishal G Shelat, Andrew Clayton Lee, Julian Wong, Karen Randhawa, CJ Shukla, Choon Sheong Seow, Tjun Tang
When planning definitive surgery, what would be the most appropriate preoperative investigation to access this?Ureteric involvement is best assessed by delayed phase CT with contrast/CT urogram (showing delayed excretory phase)
Complications Related to Neurogenic Bladder Dysfunction I
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Patients with renal stones usually have nonspecific symptoms including feeling unwell, abdominal discomfort, increased spasms, and autonomic dysreflexia (AD). A CT urogram becomes essential for diagnosis.31
Mucoid-producing lesion following hip arthroplasty
Published in Baylor University Medical Center Proceedings, 2022
Rachel Vopni, Katherine E. Dowd, Erin T. Bird
The patient was referred to our center for further evaluation. CT urogram showed no abnormality of the collecting system. Acetabular medial wall violation by the acetabular component of the hardware was illustrated, not documented on previous imaging. Urinalysis showed persistent pyuria and hematuria with two urine cultures positive for Staphylococcus aureus. Cystoscopy demonstrated a nonhealing 1 to 2 cm tract on the right posterior bladder wall with purulent efflux (Figure 1a). A right retrograde pyelogram and cystogram revealed no extravasation of contrast (Figure 1b); however, contrast injected into the fistulous tract with an open-ended ureteral catheter from the right side of the bladder toward hardware obviously demonstrated a fistulous tract and right acetabular hardware involvement (Figure 1c). Staged fistula repair was performed with a multidisciplinary approach utilizing both orthopedic and urologic surgical teams.
Renal and perinephric abscesses involving Lactobacillus jensenii and Prevotella bivia in a young woman following ureteral stent procedure
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Abhinav Mohan, Jacob Rubin, Priyank Chauhan, Juan Lemos Ramirez, German Giese
Per literature review, she was transitioned to intravenous ceftriaxone 2 g daily and metronidazole 500 mg every 8 h for the duration of her admission. Echocardiography revealed no cardiac vegetations and repeat blood cultures were negative, ruling out endocarditis. HIV testing was negative. CT abdomen/pelvis with contrast was repeated one week later, showing new right perinephric fluid collections (Figure 2). These collections were subsequently drained and found to be purulent as well. Cultures of the fluid grew P. bivia, which was confirmed with MALDI-TOF Mass Spectrometry. CT urogram was performed, showing no fistulous tracts between the genitourinary and gastrointestinal systems. Pelvic ultrasound revealed a complex ovarian cyst, but gynecological evaluation ruled this to be a benign, unrelated finding.
Nephroptosis: is body mass index (BMI) the key?
Published in Scandinavian Journal of Urology, 2018
David G. Bratt, Ata Jaffer, Lizzie Chandra, Chirag Patel, Chandra S. Biyani
It is widely appreciated that the typical patient with nephroptosis is young and female, presenting with right-sided loin pain. Associated symptoms include lower back pain, nausea, vomiting, haematuria and recurrent urinary tract infections [1]. The specific mechanism of nephroptosis symptoms remains unclear; multiple factors have been suggested, including intermittent ureteric obstruction, renal ischaemia due to elongation or kinking of the renal artery (Goldblatt’s phenomenon) and due to the traction of the vascular pedicle caused by a lack of supportive perirenal fat and fascial support leading to the downward translocation of the kidney [1,2]. To confirm the diagnosis radiological investigations: ultrasonography (US) with Doppler, Intravenous/CT urogram and radionuclide scans, either dynamic or static renal scanning in both supine and upright have been recommended. Ultrasound can demonstrate axial rotation and descent of the kidney in upright position and reproduction of symptoms. Ptosis of >5 cm may be visible on an urogram. A renogram can show decreased renal perfusion and function [1–3].