Biomedical subjects
Publications and source records attributed to Pei-Hui Chan.
Benign fibroepithelial polyps of the renal pelvis are extremely rare, and are frequently mistaken for transitional cell carcinoma. Diagnosis is usually made following nephrectomy or nephroureterectomy for an assumed malignancy of the renal pelvis. We report a 56-year-old female with a right renal pelvic fibroepithelial polyp successfully treated by percutaneous nephroscopic resection.
BACKGROUND: This retrospective study was designed to determine the efficacy of broad-spectrum antibacterials combined with percutaneous renal drainage in the treatment of emphysematous pyelonephritis (EPN). METHODS: From July 1992 to September 2002, 10 patients (nine females and one male) with EPN were managed at our institution. All patients had diabetes and presented with fever and chills, flank pain or tenderness, vomiting, and altered consciousness. The diagnosis of EPN was confirmed by the presence of intraparenchymal and/or perinephric gas in imaging studies (kidney-ureter-bladder film, sonogram, and/or computed tomography scan). Broad-spectrum antibacterial therapy, combined with percutaneous renal drainage, was started in all patients. Follow-up studies consisted of computed tomography scan and technetium-labeled diethylenetriaminepentaacetic acid (DTPA) radioisotope renography. RESULTS: The outcome was good in all patients. Three patients underwent delayed nephrectomy due to non-functioning of the involved kidney. The DTPA radioisotope renography results (glomerular filtration rate of the diseased kidney/ contralateral healthy kidney) were 0/57 mL/min, 2.7/68.1 mL/min and 3.7/63.9 mL/min. CONCLUSION: Combined broad-spectrum antibacterial therapy and percutaneous renal drainage is a safe and effective treatment for EPN, especially in high-risk patients for whom nephrectomy under general anesthesia is not feasible.
BACKGROUND: The aim of this study was to review our experience in the diagnosis and management of urolithiasis in pregnant women, and to discuss safety, appropriate diagnostic tools and treatment modalities with review of literatures. METHODS: Nine women with pregnancy proved to have urolithiasis were included in this study. The diagnosis was made according to their symptoms and signs, and ultrasonographic findings. Conservative treatment with hydration, analgesics and antibiotics was applied initially, followed by some minimally invasive procedures, including percutaneous nephrostomy (PCN), double J (DBJ) stenting and ureterorenoscopy (URS), if initial treatment failed. RESULTS: All patients received conservative treatment at first, and 4 patients got well till delivery, another 5 patients needed further minimally invasive procedures; 1 of them received DBJ stenting, another 1 received PCN first and changed to DBJ stenting. The remaining 3 patients were treated by ureterorenoscopy with stone manipulation. All these 5 patiens had full-term delivery without obstetric sequela, except 1 patient who received left salpingoophrectomy due to left ovarian abscess. CONCLUSIONS: During pregnancy, urolithiasis is a diagnostic and therapeutic challenge. Clinical symptoms and signs are most important in establishing diagnosis, and ultrasound examination adds accuracy. Minimally invasive procedures (such as PCN, DBJ stenting, URS) can facilitate the successful management of patients requiring further intervention due to failure of conservative treatment.