Benign conditions of the kidneys which could be confused in angiography with malignant neoplasms.
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Biomedical subjects
Publications and source records attributed to C Dimopoulos.
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A case of avulsion of a ureter from the pelvioureteral junction and its discharge through the vagina during an attempt to interrupt pregnancy by suction is presented. The preoperative and operative findings are described, as well as the mechanism that caused this kind of trauma. The proposed management of such a case is discussed.
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The symptomatology of testicular torsion was atypical in 16 patients among the 40 that we treated. The occurrence of fever together with the torsion (8 cases), the existence of intense local inflammatory signs (16 cases), its occurrence in adults (23 cases), ectopic testicle (2 cases), and the possibility of a traumatism (5 cases) are misleading and may delay its urgent surgical treatment. In most cases, testicular torsion forms a characteristic clinical picture with easy diagnosis, requiring most urgent operation. There are, however, cases where symptomatology is atypical and deceptive forms delay recognition of the torsion, leading to ischaemic necrosis.
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Ten cases of pheochromocytomae, of which eight were benign and two malignant have been considered. All patients presented with hypertension, either paroxysmal (7 cases) or permanent (3 cases). It is essential to emphasize that the initial symptomatology of these patients on their admission to the hospital was often atypical and misleading: in 2 cases, the symptomatology was urological, in 2 cases psychatric and in one digestive. Quantitative determination of catecholamines and their metabolites was positive in 7 cases out of 10. Retropneumoperitoneal insufflation combined with intravenous urography and tomographies provided valuable information in each case. The surgical removal of these tumours, which was unilateral and in normal position, in each case, was carried out without complications. Sudden blood pressure variations observed during the operation could be controlled without difficulty. In 6 patients, the blood pressure became normal and remained so for 4 years. In 2 other patients, the blood pressure came back to normal after the operation, but presented a slight increase 1 year later. Pheochromocytomae, which are often masked by a misleading symptomatology, must be systematically searched for in all hypertensive patients, despite the characteristics of the hypertension. Surgical removal, if done early enough, produces cure of the hypertension.
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