ECTOPIC KIDNEY(Nephroptosis). Ectopic kidney usually causes no symptoms unless complications such as ureteral obstruction or infection develop Congenital disorders. Is a low kidney on the proper side which failed to ascend normally. (Over the pelvic brim. In the pelvis).
Ectopic kidney usually causes no symptoms unless complications such as ureteral obstruction or infection develop
Congenital disorders. Is a low kidney on the proper side which failed to ascend normally. (Over the pelvic brim. In the pelvis).
Prone to ureteral obstruction and infection, which may lead to pain or fever.
Treatment: scrotal support will relieve discomfort; ligation of internal spermatic vein (at the internal inguinal ring or HIGH ligation) is indicated. The results from this operation are excellent, particularly in the treatment of infertility. Vein atomosis also applied in clinic and micro injure operation by larparoscopy is more fasionable.
Young boys with hydrocele commonly have a history of a cystic mass which is small and soft in the morning but large and more tense at night. One can only conclude, in these instances, that a small communication exists in the processus vaginalis
Hydrocele is painless unless it is accompanied by acute epididymal infection. Patient may complain of its bulk or weight.
Sever Hypertension caused by stenosis of the renal artery. Renin has been found increased amounts from the renal vein of ischemic organ.
A. Symptoms: 1.family history of hypertension, particularly young patients. 2.Sever flank pain or abdominal pain or trauma with or without hematuria(suggesting emblism or thrombosis of renal artery or an organized perirenal hematoma). 3.If there is abrupt acceleration of preexisting hypertension,esp. in an older person.
A. Symptoms: 4. In the presence of sever hypertension in any age.
B. Signs: sustained diastolic hypertension; retinas changes; renal mass may found eg, renal tumor; the presence of an aortic aneurysm or vascular insufficiency of the extremities is suggestive.
C. Lab. Findings:
Bacteria and pus cells in urine may indicate chronic pyelonephritis. In the malignant phase of hypertension, proteinuria, casts, and red cell will be seen. Total renal function is usually normal unless malignant hypertension, polycystic disease, bilateral atrophic pyelonephritis, or bilateral renal artery stenosisis present.
D. X-ray findings: excretory urography is screening test: Delay in appearance of the radiopaque medium is a importance sign. The following findings are suggestive of renal ischemic:
1. A kidney at least 1 cm shorter than its mate; 2. Lack of function of one kidney; 3. Delayed appearance of visualization on the early films; 4. Hyperconcentration of the radiopaque medium due to overabsorption of water.
E. renal isotope study: renogram and scan show slow excret of isotope.
F. Estimation of renal vein renin level: its great value in establishing the diagnosis of renovascular hypertension.
G. Renal angiography: showing significantly stenotic lesion of renal artery.
H. A positive saralasin test is strong evidence.
surgery should be done in order to protect renal function from effects of high blood perssure.
Nephrectomy. ( poor renal function)
Endarterectomy, homograft, sleeve resection of involved arterial segment. ( good renal function)
Vaso-Catheter dilatation.( micro-invade)
Renal arterial reconstruction operation. (riskness)
Control blood pressure by a-block and b-block drugs.