-
[show abstract]
[hide abstract]
ABSTRACT: Eine Hämaturie ist das häufigste klinische Symptom beim Vorliegen eines Blasentumors. Zur weiteren Abklärung gehören außer
antibiotischer Therapie bei Infektionen des Urogenitalsystems eine diagnostische Urethrozystoskopie (evtl. mit Biopsieentnahme),
eine sonographische Untersuchung der Harnorgane sowie eine bildgebende Evaluation des oberen Harntraktes (Ausscheidungsurogramm,
CT- oder MR-Urographie, retrograde Ureteropyelographie). Atypische Manifestationen systemischer Erkrankungen mit Blasenbefall
können das klinische Bild einer chronischen Zystitis vortäuschen und eine korrekte Diagnosestellung erschweren. Vorgestellt
wird ein 40-jähriger Patient mit rezidivierender Makrohämaturie bei einer extrem seltenen Blasenmanifestation eines IgM-Plasmozytoms.
Haematuria is the most common clinical symptom of bladder cancer. Besides antibiotic treatment of a probably existing urinary
tract infection, ultrasonography of the urinary organs, diagnostic cystoscopy (with biopsy if needed), and radiologic evaluation
of the upper urinary tract (intravenous urography, computed tomography or magnetic resonance urography, retrograde pyelography)
should be done for further evaluation. Atypical manifestations of systemic diseases with bladder infiltration could feign
the clinical appearance of chronic cystitis and hinder determination of the correct diagnosis. The case of a 40-year-old man
with recurrent gross haematuria due to extremely rare bladder infiltration through an IgM plasmacytoma is presented.
SchlüsselwörterPlasmozytom-IgM-Harnblase-Makrohämaturie-Chemotherapie
KeywordsPlasmacytoma-IgM-Bladder-Gross haematuria-Chemotherapy
Der Urologe 04/2012; 49(7):850-854. · 0.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Dislozierte Rippenfrakturen als Folge von verkehrsunfallbedingten Traumen können mit verschiedensten Verletzungen der Organe
des Brust- und Bauchraums einhergehen. Besonders zu befürchten sind die seltenen und schwer zu diagnostizierenden intraabdominellen
Hohlorganläsionen, die nicht rechtzeitig erkannt, den Patienten in einen septischen Schock mit einer deutlich verminderten
Überlebenswahrscheinlichkeit zu versetzen vermögen. Hier wird ein Fall eines 51-jährigen Mannes vorgestellt, bei dem eine
durch die dislozierte Rippenfraktur im Rahmen des stumpfen Thoraxtraumas bedingte Magenperforation primär nicht erkannt wurde.
Es wird das diagnostische Konzept, die damit verbundenen Herausforderungen für die Behandelnden sowie Alternativen zum Standardvorgehen
bei dislozierten Frakturen der unteren Rippen analysiert.
Dislocated rib fractures as a result of traffic accidents can be associated with various injuries of thoracic and abdominal
organs. Especial attention should be paid to rare and difficult to determine lesions of a hollow abdominal viscus, which can,
if not diagnosed early enough, lead to septic shock with a considerably diminished probability of survival. The following
case is of a 51-year-old man who suffered a blunt chest injury with dislocated rib fracture, which caused a gastric perforation
that had not been primarily detected. The diagnostic approach with its challenges for treating physicians and alternatives
to the standard procedure in the case of dislocated fractures of lower ribs is analyzed here.
Der Unfallchirurg 04/2012; 111(10):850-855. · 0.61 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Haematuria is the most common clinical symptom of bladder cancer. Besides antibiotic treatment of a probably existing urinary tract infection, ultrasonography of the urinary organs, diagnostic cystoscopy (with biopsy if needed), and radiologic evaluation of the upper urinary tract (intravenous urography, computed tomography or magnetic resonance urography, retrograde pyelography) should be done for further evaluation. Atypical manifestations of systemic diseases with bladder infiltration could feign the clinical appearance of chronic cystitis and hinder determination of the correct diagnosis. The case of a 40-year-old man with recurrent gross haematuria due to extremely rare bladder infiltration through an IgM plasmacytoma is presented.
Der Urologe 04/2010; 49(7):850-4. · 0.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Syphilis is the great imitator in medicine. Correct diagnosis of this disease can be quite difficult nowadays, after years of rare occurrence but current increasing incidence. Atypical manifestations of syphilis are often misinterpreted and lead to incorrect diagnosis and inappropriate therapy. We present the case of a 48-year-old man with recurrent penile ulcers and indurations that would temporarily heal with oral antibiotics. The most recent lesion had lasted longer than 6 weeks. Because of unsuccessful antibiotic and antiseptic treatment, we operated on the patient, suspecting penile cancer. The diagnosis of syphilis was finally performed by histology, with evolving exanthema and positive serological tests in the meantime. This case report is intended to emphasize the increased need to consider syphilis in the differential diagnosis.
Der Urologe 08/2009; 48(10):1210-3. · 0.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the incidence of voiding dysfunction in older male renal transplant recipients.
Data for 103 patients aged 60 years or older (mean age, 65.7 years; group 1) who underwent transplantation at our center between January 1999 and August 2007 were compared with data for a group of 139 younger patients (mean age, 50.1 years; group 2) treated within the same time frame.
Postoperatively, 28 group 1 recipients (27%) and 26 group 2 recipients (19%) experienced voiding dysfunction after removal of the transurethral catheter (P = .12). The most common cause was bladder outlet obstruction due to benign prostatic hyperplasia in 26 patients in group 1 (25%) and 17 patients in group 2 (12%) (P = .009). Bladder neck contracture, urethral stricture, and detrusor underactivity were diagnosed in the other patients. Transurethral resection of the prostate gland was performed in 21 group 1 patients (20%) and 14 group 2 patients (10%) (P = .02) at a mean of 31.1 and 29.5 days, respectively (P = .23) after transplantation. Surgical procedures were performed without complication, and symptoms did not recur postoperatively.
Our data reveal a high incidence of voiding dysfunction in older male renal transplant recipients. High residual urine and urinary retention after renal transplantation may induce recurrent urinary tract infections, cause relevant complications, and seriously affect graft function. Recognizing the substantial effects of postoperative voiding dysfunction will enable optimum management of older kidney transplant recipients.
Transplantation Proceedings 07/2009; 41(5):1615-8. · 1.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Dislocated rib fractures as a result of traffic accidents can be associated with various injuries of thoracic and abdominal organs. Especial attention should be paid to rare and difficult to determine lesions of a hollow abdominal viscus, which can, if not diagnosed early enough, lead to septic shock with a considerably diminished probability of survival. The following case is of a 51-year-old man who suffered a blunt chest injury with dislocated rib fracture, which caused a gastric perforation that had not been primarily detected. The diagnostic approach with its challenges for treating physicians and alternatives to the standard procedure in the case of dislocated fractures of lower ribs is analyzed here.
Der Unfallchirurg 02/2008; 111(10):850-5. · 0.61 Impact Factor
