RESUMO
Renal cell carcinoma is the major cause of kidney malignancy. Its adrenal metastasis is less frequent and is even rarer when it is affected contralaterally or bilaterally. We present the case of a 55-year-old man with diffuse abdominal pain. An irregular mass in the lower third of the left renal cortex and another in the right adrenal gland. Pathology showed it was a renal cell carcinoma with metastasis in the contralateral adrenal gland.
RESUMO
Subcapsular hematoma is an uncommon complication after ureteroscopy and laser lithotripsy. We report on a 38-year-old male with an 8 mm lower pole stone who underwent a left ureteroscopy and laser lithotripsy. The stone was successfully fragmented. Several hours after being discharged home, the patient returned complaining of back pain and hematuria. He was hemodynamically stable. Laboratory exams were normal. A CT study showed a crescent renal subcapsular hematoma surrounding the left kidney. The patient was admitted to the ward for conservative treatment. No additional intervention was necessary. Most subcapsular hematomas tend to resolve spontaneously.
Assuntos
Hematoma , Rim/diagnóstico por imagem , Litotripsia a Laser/efeitos adversos , Hemorragia Pós-Operatória , Ureterolitíase/cirurgia , Ureteroscopia/efeitos adversos , Adulto , Drenagem/métodos , Hematoma/diagnóstico , Hematoma/etiologia , Hematoma/fisiopatologia , Hematoma/terapia , Humanos , Litotripsia a Laser/métodos , Masculino , Medição da Dor/métodos , Hemorragia Pós-Operatória/diagnóstico , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/fisiopatologia , Hemorragia Pós-Operatória/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ureterolitíase/diagnóstico , Ureterolitíase/fisiopatologia , Ureteroscopia/métodosRESUMO
The main goals for urinary stone treatment are to preserve renal function, reduce or avoid complications related to calculi, and to render the patient free of calculi as soon as possible. Anatrophic nephrolithotomy (ANL) is a valid and useful alternative for conventional staghorn calculi excision. Although excellent stone free rates can be achieved with ANL there are some drawbacks that may be of concern. Morbidity related to intraoperative and postoperative complications is one of them. Another, great concern is the possibility of reduction on renal function related to the procedure itself. This may be related to nephron injury during nephrotomy and parenchymal closure or to ischemic injury. In this review we assess functional results after anatrophic nephrolithotomy.
