Vanishing spleen syndrome post right partial nephrectomy in a sicklemic patient.

Splenic infarction after contralateral laparoscopic renal surgery has not, to our knowledge, been reported. The spleen is the most affected organ in sickle cell disease and the mechanism of auto infarction is thought to result from the crystallization of abnormal hemoglobin during periods of hypoxia or acidosis resulting in parenchymal ischemia and ultimately tissue necrosis. We report a case of 45 year old female with sickle cell disease who had an unremarkable spleen at the time of a laparoscopic right partial nephrectomy and was subsequently found to have marked diminution in her splenic volume.

Incidental Finding of Urethral Diverticulum in a Woman with History of Recurrent Urinary Tract Infections.

We present an incidental finding and management of a urethral diverticulum containing mixed composition of struvite and ammonium urate stones. Status post sleeve gastrectomy, patient presented to our bariatric clinic with epigastric pain associated with nausea and vomiting. A computed tomography scan was performed to rule out any complications of the procedure in which urethral stones were reported contained within a diverticulum. This finding, in retrospect, correlated with patient's past history of recurrent urinary tract infections. Over all, urethral diverticulum with struvite stones is a rare entity with few reported cases in literature thus a high index of suspicion is needed in patients with related symptoms. Here a case presentation and treatment rationale are described along with a brief review of existing literature.

Retroperitoneal Pseudoaneurysm Mimicking Ureteral Calculus: Pitfalls in Diagnosis.

Arterial aneurysms (AA) can be classified as true aneurysms, characterized by the persistence of all three layers of the arterial wall with progressive dilation and wall thinning; arterial pseudoaneurysms (APAs) are characterized by a tear in the vessel wall and a periarterial hematoma formation. They could occur due to a visceral, retroperitoneal, or peripheral origin. Most AA/APA are usually found incidentally, and it is imperative to be vigilant in order to diagnose and manage them due to their potentially life-threatening complications. We present a case of a 35-year-old woman presenting with right-sided abdominal pain mimicking renal colic with an initial misdiagnosis of ureteral calculus. Post-cystoscopy, a misdiagnosis was confirmed, and subsequently, the patient had a right retroperitoneal mass excision. The histopathology report concluded the calcified retroperitoneal mass to be pseudoaneurysm. Such pitfalls in diagnosis are essential to be shared with the larger medical community for increased vigilance and optimal management of pseudoaneurysms.