摘要:

A 48-year-old woman on maintenance hemodialysis was admitted with her left upper limb swollen and her left jugular vein dilated following the creation of an arteriovenous fistula on her left arm. The intracorporeal pressure during hemodialysis was found to be high. Venographic investigation showed severe stenosis of her left innominate vein accompanied by rich blood flow of the collaterals. Ligation of her fistula promptly reduced swelling of her left upper limb and dilatation of the left jugular vein. The exact cause of the stenosis could not be determined from venographic or computerized tomography findings. Idiopathic left innominate vein stenosis was diagnosed which we believe is the first case to be reported in a hemodialyzed patient.

ISSN:0250-8095    

DOI:10.1159/000168703

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Water diuresis after head trauma is most often due to central diabetes insipidus (DI). We report a patient with a history of a bipolar disorder and past lithium use who was noted to have polyuria and hypernatremia after head trauma. Inappropriate high sodium and volume replacement resulted in an increase in the polyuria. A lack of response to antidiuretic hormone/antidiuretic-hormone-like preparations led to the diagnosis of nephrogenic DI. The case illustrates the importance of calculating electrolyte-free osmolar clearance in the correction of hypernatremia. Persistence of the DI and mild renal impairment probably due to past lithium use are discussed.

ISSN:0250-8095    

DOI:10.1159/000168704

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Primary renal lymphoma is a controversial entity. Only 29 cases have been reported since 1980. Diagnostic criteria are not well established. We report here 3 new cases and review the literature. Primary renal lymphoma was considered on the basis of uni- or bilateral nonobstructive nephromegaly with or without renal failure. In all cases, the diagnosis was made after renal biopsy. Extrarenal abdominal involvement was excluded by imaging techniques. The role of staging laparotomy remains controversial. Chemotherapy is the treatment of choice, but the prognosis is poor. We propose a clinical definition of primary renal lymphoma in order to achieve a better management of the disease.

ISSN:0250-8095    

DOI:10.1159/000168705

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Lymphoceles occurring after renal transplantation are frequently asymptomatic and are usually identified on routine ultrasonogrpahy of the allograft. A small percentage of them may increase in size and manifest due to their compression effects on adjacent structures or as lymphocutaneous fistula. An infected lymphocele would, in addition, give rise to local and systemic features. A case of infected lymphocele occurring 4.5 months after cadaveric renal transplant is reported. The patient presented in septicemia and features of generalized peritonitis. Emergency diagnostic laparoscopy revealed fluid collection in the peritoneal cavity. However, on exploratory laparotomy no intra-abdominal pathology was detected. Further evaluation revealed a large perigraft lymph collection which was drained percutaneously. Fluid and blood cultures grew Staphylococcus aureus. The patient recovered completely following external drainage and antibiotic administration.

ISSN:0250-8095    

DOI:10.1159/000168706

出版商:S. Karger AG    

年代:1994

数据来源: Karger