RESUMO
Bilateral arteriovenous fistulas secondary to percutaneous needle biopsy of each kidney developed in a patient with malignant hypertension and chronic failure. The fistulas with aneurysmal formation and hematuria were of such magnitude that bilateral nephrectomy was required for control. The patient is now normotensive and is maintained on hemodialysis. The advisability of renal needle biopsy in uncontrolled hypertension is questioned. Cases of intrarenal arteriovenous fistulas resulting from percutaneous needle biopsy of the kidney are being reported with increasing frequency. The exact incidence of fistula formation after kidney biopsy is unknown, but several series based on arteriographic studies show an incidence as high as 18 per cent. Although many of these fistulas disappear spontaneously, approximately 4 per cent persist. A review of the literature failed to reveal the incidence of aneurysmal formation. Our case was complicated by formation of bilateral renal arteriovenous fistulas secondary to repeat bilateral percutaneous needle biopsy and right open renal biopsy. Subsequent gross hematuria from the right ureteral orifice also resulted which was proved by cystoscopy and required replacement with several units of blood. The likelihood of rupture led to bilateral nephrectomy.
Assuntos
Fístula Arteriovenosa/etiologia , Biópsia por Agulha/efeitos adversos , Hipertensão Maligna/complicações , Falência Renal Crônica/complicações , Artéria Renal , Veias Renais , Adulto , Fístula Arteriovenosa/complicações , Fístula Arteriovenosa/cirurgia , Hematúria/etiologia , Humanos , Doença Iatrogênica , Masculino , Nefrectomia , Diálise RenalRESUMO
Acid phosphatase levels in serum from 5 patients with prostatic carcinoma were diagnostically higher than those from 5 patients who had undergone prostatectomy. The levels for saliva when compared with those from normal subjects for stimulated (314) and unstimulated (50) salivas could not serve as an index of serum concentration.
Assuntos
Fosfatase Ácida/análise , Neoplasias da Próstata/enzimologia , Saliva/enzimologia , Adulto , Humanos , Masculino , Metástase Neoplásica , Glândula Parótida/metabolismo , Prostatectomia , Neoplasias da Próstata/cirurgia , Saliva/metabolismo , Taxa SecretóriaRESUMO
Microcrystalline collagen has been reported to be an effective hemostatic agent in brain, liver, kidney, etc. This experimental study in dogs and rats shows that microcrystalline collagen is a more effective hemostat in prostatic hemorrhage than is purified gelatin solution. No gross or histologic evidence of tissue damage or calcification was induced by microcrystalline collagen or purified gelatin solution. Wafers of microcrystalline collagen that are placed in rat bladders dissolve and do not induce calculogenesis.