[Diagnosis and therapy of acute ureteral colic]. / Diagnostik und Therapie der Harnleitersteinkolik.

Acute ureteral colic presents with a complex of acute and characteristic flank pain that usually indicates the presence of a stone in the urinary tract. Diagnosis and management of renal colic have undergone considerable evolution and advancement in recent years. The application of noncontrast helical computed tomography (CT) in patients with suspected ureteral colic is one major advance in the primary diagnostic process. The superior sensitivity and specificity of helical CT allow ureterolithiasis to be diagnosed without the potential side effects of contrast media. Initial management is based on three key concepts: (A) rational and fast diagnostic process (B) effective pain control (C) and understanding of the impact of stone location and size on the natural course of the disease and definitive urologic management. These concepts are discussed in this review with reference to contemporary literature.

Endoscopic management of bisected hemidiaphragm during retroperitoneoscopic donor nephrectomy.

Retroperitoneoscopy is our preferred technique for renal surgery and is routinely performed for living donor nephrectomy. We report a case of a totally bisected left hemidiaphragm during left-sided retroperitoneoscopic donor nephrectomy. This was most likely caused when creating the retroperitoneal working space by balloon dilation. Because the cardiopulmonary situation of the patient remained stable, retroperitoneoscopic donor nephrectomy was performed with the standard technique. This report describes for the first time the retroperitoneoscopic reconstruction of a diaphragmatic injury.