Subepithelial hemorrhage in the renal pelvis and ureter simulating pyeloureteritis cystica

Thompson, Jay S.; McAlister, William H.

doi:10.1007/bf01006902

Cited by 12 publications

(3 citation statements)

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“…In an extensive review of the literature, both in English and other languages, 20 previously reported cases in children were found. Of these, 11 have been reported in the English literature [2][3][4][5][6][7][8][9][10]. The paper presented here is the first extensive review of HSP-associated ureteritis.…”

Section: Cs Remissionmentioning

confidence: 94%

“…In addition, cyclophosphamide administration was also ineffective in preventing or treating ureteritis. On the other hand, remission has been reported in patients without any treatment [2,12,13,20]. Progressive stenosis requiring surgical intervention despite early corticosteroid treatment due to gastrointestinal or renal involvement has also been reported [5,9,11,19].…”

Section: Cs Remissionmentioning

confidence: 97%

“…Involvement of the lower urinary tract seems unusual, and only few cases of HSP-associated stenosing ureteritis, typically presenting with severe manifestations, have been reported in the English literature [2][3][4][5][6][7][8][9][10]. However, the true incidence and spectrum of this complication remains unknown, as some cases were diagnosed incidentally [7,9,[11][12][13][14].…”

Section: Introductionmentioning

confidence: 98%

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Masked severe stenosing ureteritis: a rare complication of Henoch-Schönlein purpura

et al. 2008

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Henoch-Schönlein purpura (HSP)-associated stenosing ureteritis represents a rare complication of the disease, typically presenting with severe manifestations. This article reports on a 3.5-year-old boy with HSP and severe nephritis who developed a unilateral stenosing ureteritis with atypical manifestations, resulting in a nonfunctional kidney and consequent nephrectomy. The urinary tract ultrasound was normal in the first week of illness, and the diagnosis was made during follow-up 8 months after onset. The predominance of nephritic manifestations may have masked any signs of ureteritis, leading to the delay in diagnosis. To clarify the clinical spectrum of this complication, an extensive review of the literature was performed. We emphasize the necessity of repeated urinary tract ultrasound both early and later in the course of HSP, especially in cases with renal involvement, so that an early diagnosis of this complication can prevent a potentially serious renal outcome.

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Section: Cs Remissionmentioning

confidence: 94%

Section: Cs Remissionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 98%

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Masked severe stenosing ureteritis: a rare complication of Henoch-Schönlein purpura

et al. 2008

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Ultrasound demonstration of renal pelvic urine‐debris levels caused by blood clot: Association with subepithelial hemorrhage

Dyer

Glass

Tegtmeyer

et al. 1984

J of Clinical Ultrasound

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Renal pelvic urine-debris levels, and submucosal filling defects, two uncommon radiographic manifestations of genitourinary tract bleeding, were encountered in a patient on anticoagulant therapy. The sonographic, and pyelographic appearance is illustrated, and possible diagnostic confusion with other disease processes discussed. CASE REPORTA 67-year-old woman was referred for evaluation and therapy of recurrent carcinoma of the bladder with known local pelvic metastasis. Pertinent laboratory data included prothrombin time (PT) of 10.0 seconds (control 9.0-12.5 seconds), partial thromboplastin time (PTT) of 27.4 seconds (control 26.0-40.0 seconds) and normal platelet count. Blood urea nitrogen (BUN) and serum creatinine were normal. The urinalysis showed numerous red blood cells but urine culture was negative for bacterial growth. Preoperative evaluation included abdomino-pelvic computed tomography (CT) which documented local pelvic tumor invasion from the patient's primary bladder carcinoma, with normal upper urinary tracts.The patient underwent radical cystectomy with creation of an ileal conduit. Postoperatively, she was afebrile and urine output, BUN, and creatinine remained normal. Three weeks after surgery, she developed thrombophlebitis of her left leg. Intravenous Heparin therapy was initiated, and this was followed by oral anticoagulation with sodium warfarin (Coumadin). During Six weeks after surgery, she developed a decreased urinary output and an elevated BUN and creatinine. PT at this time was 30.5 seconds. Renal ultrasound [ Fig. 1(A), 1(B)1 performed to rule out obstruction showed bilateral hydronephrosis with urine-debris levels on the left, and echogenic material in the dependent portions of the collecting system on the right. On the following day, the urinary tracts were decompressed with bilateral percutaneous nephrostomies (PN) and internal ureteral stents. Selective renal pelvic urine samples obtained at the time of entry into the renal pelves were negative for bacterial growth. Antegrade pyelography at the time of PN (Fig. 2) confirmed the presence of intrapelvic debris, and showed submucosal defects. Irrigation of the renal pelvis revealed urine containing old and new blood clots. Following internal stent placement, urine output improved and a repeat pyelogram 2 days later at the time of external catheter removal (Fig. 3) revealed decompression of the collecting systems bilaterally and a decrease in the amount of intrapelvic debris. Residual submucosal filling defects were present. Bleeding into the urinary tract was felt to account for the radiographic findings. Following withdrawal of anticoagulant therapy, the patient's urine output increased, and BUN and creatinine returned to normal. The patient was discharged with internal stents in place.

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Miscellaneous

Bouchard

Rischmann

Smayra

et al. 2003

Radiological Imaging of the Ureter

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Subepithelial hemorrhage in the renal pelvis and ureter simulating pyeloureteritis cystica

Cited by 12 publications

References 5 publications

Masked severe stenosing ureteritis: a rare complication of Henoch-Schönlein purpura

Masked severe stenosing ureteritis: a rare complication of Henoch-Schönlein purpura

Ultrasound demonstration of renal pelvic urine‐debris levels caused by blood clot: Association with subepithelial hemorrhage

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