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Nephrostomy
A nephrostomy or percutaneous nephrostomy is an artificial opening created between the kidney and the skin which allows for the urinary diversion directly from the upper part of the urinary system ( renal pelvis). It is an interventional radiology/surgical procedure in which the renal pelvis is punctured whilst using imaging as guidance. Images are obtained once an antegrade pyelogram (an injection of contrast), with a fine needle, has been performed. A nephrostomy tube may then be placed to allow drainage. An urostomy is a related procedure performed more distally along the urinary system to provide urinary diversion. Uses A nephrostomy is performed whenever a blockage keeps urine from passing from the kidneys, through the ureter and into the urinary bladder. Without another way for urine to drain, pressure would rise within the urinary system and the kidneys would be damaged. The most common cause of blockage necessitating a nephrostomy is cancer, especially ovarian canc ...
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Ureter
The ureters are tubes composed of smooth muscle that transport urine from the kidneys to the urinary bladder. In an adult human, the ureters typically measure 20 to 30 centimeters in length and about 3 to 4 millimeters in diameter. They are lined with urothelial cells, a form of transitional epithelium, and feature an extra layer of smooth muscle in the lower third to aid in peristalsis. The ureters can be affected by a number of diseases, including urinary tract infections and kidney stone. is when a ureter is narrowed, due to for example chronic inflammation. Congenital abnormalities that affect the ureters can include the development of two ureters on the same side or abnormally placed ureters. Additionally, reflux of urine from the bladder back up the ureters is a condition commonly seen in children. The ureters have been identified for at least two thousand years, with the word "ureter" stemming from the stem relating to urinating and seen in written records since at ...
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Nephrolithiasis
Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of crystal to aggregate and form hard masses, or calculi (stones) in the upper urinary tract. Because renal calculi typically form in the kidney, if small enough, they are able to leave the urinary tract via the urine stream. A small calculus may pass without causing symptoms. However, if a stone grows to more than , it can cause blockage of the ureter, resulting in extremely sharp and severe pain (renal colic) in the lower back that often radiates downward to the groin. A calculus may also result in blood in the urine, vomiting (due to severe pain), or painful urination. About half of all people who have had a kidney stone are likely to develop another within ten years. ''Renal'' is Latin for "kidney", while "nephro" is the Greek equivalent ...
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Interventional Radiology
Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as Fluoroscopy, x-ray fluoroscopy, CT scan, computed tomography, magnetic resonance imaging, or ultrasound. IR performs both diagnostic and therapeutic procedures Minimally invasive procedure, through very small incisions or body orifices. Diagnostic IR procedures are those intended to help make a diagnosis or guide further medical treatment, and include image-guided biopsy of a tumor or injection of an Radiocontrast agent, imaging contrast agent into a hollow structure, such as a blood vessel or a Bile duct, duct. By contrast, Therapy, therapeutic IR procedures provide direct treatment—they include catheter-based medicine delivery, medical device placement (e.g., stents), and angioplasty of narrowed structures. The main benefits of IR techniques are that they can reach the deep structures of the body through a body orifice or tiny incisi ...
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Pyelogram
Pyelogram (or pyelography or urography) is a form of imaging of the renal pelvis and ureter. Types include: * Intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system. * Retrograde pyelogram – Any pyelogram in which contrast medium is introduced from the lower urinary tract and flows toward the kidney (i.e. in a "retrograde" direction, against the normal flow of urine). * Anterograde pyelogram (also antegrade pyelogram) – A pyelogram where a contrast medium passes from the kidneys toward the bladder, mimicking the normal flow of urine. * Gas pyelogram – A pyelogram that uses a gaseous rather than liquid contrast medium. It may also form without the injection of a gas, when gas producing micro-organisms infect the most upper parts of urinary system. Intravenous pyelogram An intravenous pyelogram (IVP), also called an intravenous urogram (IVU), is a radiological procedure used to visualize abnormalities of the urinary ...
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Interventional Radiology
Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as Fluoroscopy, x-ray fluoroscopy, CT scan, computed tomography, magnetic resonance imaging, or ultrasound. IR performs both diagnostic and therapeutic procedures Minimally invasive procedure, through very small incisions or body orifices. Diagnostic IR procedures are those intended to help make a diagnosis or guide further medical treatment, and include image-guided biopsy of a tumor or injection of an Radiocontrast agent, imaging contrast agent into a hollow structure, such as a blood vessel or a Bile duct, duct. By contrast, Therapy, therapeutic IR procedures provide direct treatment—they include catheter-based medicine delivery, medical device placement (e.g., stents), and angioplasty of narrowed structures. The main benefits of IR techniques are that they can reach the deep structures of the body through a body orifice or tiny incisi ...
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Pyelogram
Pyelogram (or pyelography or urography) is a form of imaging of the renal pelvis and ureter. Types include: * Intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system. * Retrograde pyelogram – Any pyelogram in which contrast medium is introduced from the lower urinary tract and flows toward the kidney (i.e. in a "retrograde" direction, against the normal flow of urine). * Anterograde pyelogram (also antegrade pyelogram) – A pyelogram where a contrast medium passes from the kidneys toward the bladder, mimicking the normal flow of urine. * Gas pyelogram – A pyelogram that uses a gaseous rather than liquid contrast medium. It may also form without the injection of a gas, when gas producing micro-organisms infect the most upper parts of urinary system. Intravenous pyelogram An intravenous pyelogram (IVP), also called an intravenous urogram (IVU), is a radiological procedure used to visualize abnormalities of the urinary ...
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Ovarian Cancer
Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different cell types including epithelial cells, germ cells, and stromal cells. When these cells become abnormal, they have the ability to divide and form tumors. These cells can also invade or spread to other parts of the body. When this process begins, there may be no or only vague symptoms. Symptoms become more noticeable as the cancer progresses. These symptoms may include bloating, vaginal bleeding, pelvic pain, abdominal swelling, constipation, and loss of appetite, among others. Common areas to which the cancer may spread include the lining of the abdomen, lymph nodes, lungs, and liver. The risk of ovarian cancer increases with age. Most cases of ovarian cancer develop after menopause. It is also more common in women who have ovulated ...
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Kidney
In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organ (anatomy), organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal artery, renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the urinary bladder, bladder. The kidney participates in the control of the volume of various body fluids, fluid osmolality, Acid-base homeostasis, acid-base balance, various electrolyte concentrations, and removal of toxins. Filtration occurs in the glomerulus (kidney), glomerulus: one-fifth of the blood volume that enters the kidneys is filtered. Examples of substances reabsorbed are solute-free water, sodium, bicarbonate, glucose, and amino acids. Examples of substances secreted are hy ...
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Hydronephrosis
Hydronephrosis is the hydrostatic dilation of the renal pelvis and Renal calyx, calyces as a result of obstruction to urine flow downstream. Alternatively, hydroureter describes the dilation of the ureter, and hydronephroureter describes the dilation of the entire upper urinary tract (both the renal pelvicalyceal system and the ureter). Signs and symptoms The signs and symptoms of hydronephrosis depend upon whether the obstruction is Acute (medicine), acute or Chronic (medicine), chronic, partial or complete, unilateral or bilateral. Hydronephrosis that occurs acutely with sudden onset (as caused by a kidney stone) can cause intense pain in the flank area (between the hips and ribs) known as a renal colic. Historically, this type of pain has been described as "Dietl's crisis". Conversely, hydronephrosis that develops gradually over time will generally cause either a dull discomfort or no pain. Nausea and vomiting may also occur. An obstruction that occurs at the urethra or bla ...
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Pyonephrosis
Pyonephrosis () is a dangerous kidney infection that is characterized by pus accumulation in the renal collecting system. It is linked to renal collecting system blockage and suppurative renal parenchymal destruction, which result in complete or nearly complete kidney failure. Signs and symptoms Clinical symptoms in patients with pyonephrosis can range from frank sepsis (15%) to asymptomatic bacteriuria. Upon physical examination, the hydronephrotic kidney may be linked to a palpable abdominal mass. On rare occasions, the hydronephrotic kidney infection may burst spontaneously into the peritoneal cavity, resulting in diffuse peritonitis and sepsis in certain patients. Cause Pyonephrosis can result from an upper urinary tract infection combined with blockage and hydronephrosis. Diagnosis When a patient has suspected pyonephrosis, the initial workup should consist of a complete blood count, serum chemistry with blood urea nitrogen (BUN) and creatinine, blood cultures, ...
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Fluoroscopy
Fluoroscopy (), informally referred to as "fluoro", is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a surgeon to see the internal anatomy, structure and physiology, function of a patient, so that the pumping action of the heart or the motion of swallowing, for example, can be watched. This is useful for both medical diagnosis, diagnosis and therapy and occurs in general radiology, interventional radiology, and image-guided surgery. In its simplest form, a fluoroscope consists of an X-ray generator, X-ray source and a fluorescence, fluorescent screen, between which a patient is placed. However, since the 1950s most fluoroscopes have included X-ray image intensifiers and cameras as well, to improve the image's visibility and make it available on a remote display screen. For many decades, fluoroscopy tended to produce live pictures that were not recorded, bu ...
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Renal Calyx
The renal calyces ( calyx) are conduits in the kidney through which urine passes. The minor calyces form a cup-shaped drain around the apex of the renal pyramids. Urine formed in the kidney passes through a renal papilla at the apex into the minor calyx; four or five minor calyces converge to form a major calyx through which urine passes into the renal pelvis (which in turn drains urine out of the kidney through the ureter). Function Peristalsis of the smooth muscle originating in pace-maker cells originating in the walls of the calyces propels urine through the renal pelvis and ureters to the bladder. The initiation is caused by the increase in volume that stretches the walls of the calyces. This causes them to fire impulses which stimulate rhythmical contraction and relaxation, called peristalsis. Parasympathetic innervation enhances the peristalsis while sympathetic innervation inhibits it. Clinical significance A " staghorn calculus" is a kidney stone that may exten ...
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