RESUMO
OBJECTIVES: To report the case of a 28-year-old female patient carrying a lithiasis of soft appearance located within a calyceal diverticulum in the right kidney which presented clinically during pregnancy, and to comment on therapeutic management, as well as the outcome one year after conservative treatment. METHODS AND RESULTS: 28-year-old female patient with history of renal colic during pregnancy, who presents at our clinics in the postpartum period with a recurrent abdominal and lumbar pain. Kidney-ureter-bladder (KUB) x-ray and intravenous urography (IVP) detected a lithiasis of soft appearance within a calyceal diverticulum in the right kidney. Treatment was conservative with potassium citrate/citric acid and follow-up controls with urine culture (every 3 months) and ultrasounds (every 8 months). Currently she is asymptomatic but the lithiasis persists on KUB and urine culture is positive (Escherichia coli) and receives treatment with cefuroxime 250 mg every 12 hours for 6 days and nitrofurantoin 100 mg every night for three months. CONCLUSIONS: Most urinary stones located within calyceal diverticula have an asymptomatic course, treatment not being necessary. The most frequent clinical presentations of these stones are flank pain, urinary infection demonstrated by positive urine culture, and incidental finding. IVU is an effective method for diagnosis. ESWL is not an effective treatment for them, being percutaneous techniques the most suitable for a single-surgical procedure resolution of both lithiasis and pyelocalyceal diverticulum.
Assuntos
Divertículo/complicações , Cálculos Renais/complicações , Nefropatias/etiologia , Adulto , Antibacterianos/uso terapêutico , Divertículo/diagnóstico por imagem , Feminino , Humanos , Rim/diagnóstico por imagem , Rim/patologia , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/terapia , Nefropatias/diagnóstico por imagem , Nefropatias/terapia , Resultado do Tratamento , Ultrassonografia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/etiologia , UrografiaRESUMO
OBJECTIVES: To report three cases of uterine myoma as cause of pelvic calcification and to establish differential diagnosis with bladder stones. METHODS/RESULTS: Three asymptomatic female patients, ages between 54 years (one patient) and more than 70 years (two patients), were fortuitously found to have calcified uterine myomas by radiological studies made for suspicion of other pathologies. CONCLUSIONS: Discovering of calcified uterine myomas is not frequent. Diagnosis is made by radiological studies in postmenopausal female patients. The significance from the urological point of view is to do differential diagnosis with bladder stones.