Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of retroperitoneal tissue marked by chronic inflammation and prominent fibrosis. A 67-year-old man presented with general weakness and oliguria. Laboratory findings showed blood urea nitrogen 77.7 mg/dL, serum creatinine 9.24 mg/dL, and an IgG4 level within the normal range. Computed tomography (CT) findings showed bilateral hydronephrosis and distal ureteral obstruction due to fibrotic adhesion to a presacral mass. Laparoscopic biopsy was performed. The authors report a case of acute kidney injury caused by non-IgG4 related focal retroperitoneal fibrosis in the pelvis that was successfully treated using prednisolone and tamoxifen… non-IgG4 related focal retroperitoneal fibrosis caused byacute kidney injury.
Micrococcus lutus is common gram-positive aerobic cocci present in soil, water, dust, and the skin of humans and animals. A 72-year-old man was admitted to the hospital with a complaint of abdominal pain and a turbid peritoneal dialysate. He was empirically treated with intraperitoneal (IP) cefazolin and ceftazidime. Seven day after admission, Gaffkya species was identified from the peritoneal effluent. He was treated with same organism one month ago and discharged with the dialysis catheter intact. So, we suspected that organism is true pathogen, and identified M. luteus by culture. We changed the antibiotics to cefoxitin, which were given for the total of 14 days. This is the first report of relapsing peritonitis by M. luteus and successful treatment without catheter removal.
Acute tubular necrosis (ATN) is a syndrome of intrinsic renal injury secondary to ischemic or toxic causes without parenchymal damages and usually non-oliguria. A 20-year old man presented with acute renal failure preceded by 2 days of watery diarrhea. He had been anuria for 48hr with intravenous fluid therapy. Oliguria persisted for 10 days and he required hemodialysis support for 6 days before renal recovery. He denied the use of any regular medication and any intravenous drug use. Renal biopsy revealed severe ATN. Histopathologic findings were marked desquamation of proximal tubular epithelial cells with intact distal tubules and normal glomeruli. We report an unusual case of ATN with anuria and clinically severe features.
Hydroureter could occur in a state where the whole ureter was remarkably expanded. The causes of occurrence are anatomi-cal urinary tract obstruction or vesicoureteral reflux, and it could occur unilaterally or bilaterally according to its reason. A 38-year-old man presented with left flank pain. Abdominal CT showed a severely atrophied left kidney and a large retroperi-toneal cyst near the left kidney. The pathologic finding showed that the cyst wall is composed of transitional epithelium, lamina propria, muscle, and adventitia, and final diagnosis was hydroureter. The unilateral marked hydroureter misdiagnosed as a retroperitoneal cyst was quite rare. We report on this rare case with literature.
Polyethylene glycol (PEG) solution is currently used to prepare the colon before colonoscopy. Hyponatremic encephalopathy is a condition with neurologic symptoms such as headache, vomiting, confusion, seizure, and sometimes respiratory arrest. A 55-year-old woman presented to our emergency department with generalized tonic-clonic seizure and mental change after ingestion of PEG solution 2 L with water. Serum sodium concentrations was 115 mmol/L. After correction with hypertonic saline for 12hrs, serum sodium concentration reached 129 mmol/L and mental status recovered. We experienced a case of acute hyponatremic encephalopathy resulting from ingestion of PEG solution 2 L for colonoscopy.
Peritonitis is a common, major complication in continuous ambulatory peritoneal dialysis (CAPD) patients and tuberculous (TB) peritonitis has been reported to constitute 1-2% of all peritonitis cases. In CAPD patients, TB peritonitis is often diagnosed late and has a high mortality rate. In a recent recommendation made regarding the treatment of TB peritonitis, primary removal of a peritoneal dialysis catheter has been advised in addition to anti-TB drugs. Here, we describe two cases of TB peritonitis in CAPD patients successfully treated without peritoneal dialysis catheter removal.