Biomedical subjects
Publications and source records attributed to A D Vargas.
A case of leiomyoma of the bladder is presented. The symptoms of this rare benign tumor depend on the size, location, or associated urinary tract infection. The diagnosis may be confirmed by transurethral biopsy, and, since these tumors are well encapsulated, the treatment of choice is total enucleation from the vesical wall. Transurethral resection as a definitive modality of treatment should be attempted only in small tumors.
There were 95 patients (105 kidneys) with staghorn calculi evaluated clinically and 84 kidneys were studied on a pathologic basis. Only 1 percent of the patients could be defined as having a silent stone calculus. Clinical complications occurred in 53 per cent of the patients. Of 84 kidneys submitted for a pathoanatomic study (surgical evaluation and/or histopathology) pyonephrosis was found in 20 per cent, xanthogranulomatous pyelonephritis in 8 per cent, end stage pyelonephritic kidney in 6 per cent, end state hydronephrotic kidney in 7 per cent, severe pyelonephritic changes in 7 per cent and a perinephric abscess in 5 per cent. The kidney was considered to be relatively undamaged in 51 per cent of the cases. Complete removal of the calculus and appropriate medical adjunctive therapy should be done early in the course of the disease in an attempt to prevent complications and renal deterioration. The results of treatment are discussed and compared to those obtained in a group of patients who initially were managed conservatively.
This constitutes the twelfth case of adrenal hemangioma reported to date. The clinical presentation, radiographic characteristics, and management are reviewed. Although rare, these tumors should be part of the differential diagnosis in adrenal neoplasms.
A fluorinated tissue adhesive Fluoroalkyl Cyanoacrilate has been used in end-to-end ureteral anastomoses as an adjunct to suture material to avoid urinary extravasation in seven dogs. A similar number of dogs served as controls. The urinary tracts were evaluated grossly, radiographically, and histologically after 3 to 12 months. Better anatomical results and less inflammatory reaction and fibrosis were found in the group submitted to the tissue adhesive.
A case of prune belly syndrome that was managed at birth with cutaneous ureterostomies and later reconstructed with a pyeloileovesical diversion (reversed 7) is presented. This constitutes the first report of such treatment in this anomaly. The indications, operative procedure and results after long-term followup are discussed.
A case of left renocolic fistula secondary to chronic pyonephrosis has been reported. Neprectomy, excision of the fistulous tract, and closure of the colon is the treatment of choice. This was accomplished in this case with excellent results.
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