A retrospective analysis of the ultrasonographic findings of 9 cases of tuberculous abscess, 5 cases of pyogenic abscess and 2 cases of hematoma of psoas and adjacent muscles was made. Fluid collection with or without internal echoes was seen in 12 cases out of total 16 cases. Other findings were 2 cases of only muscle swelling, 1 case of highly echogenic mass.like appearance and 1 case of fluid collection with septae. Ultrasonography is considered an accurate method in identifying early pathologic changes of the psoas muscle and determining its extent. and in differentiating tumor from fluid collection of the psoas muscle. Authors dare to say that ultrasound examination is a procedure of choice in the diagnosis of psoas abscess and hematoma.
Abscess ; Diagnosis ; Hematoma ; Methods ; Muscles ; Psoas Abscess ; Psoas Muscles ; Retrospective Studies ; Ultrasonography

The lumbar sympathetic ganglion block (LSGB) is widely used for diagnosing and treating sympathetically maintained pain disorders. The LSGB has been conventionally carried out under fluoroscopy or computed tomography guidance. However, as ultrasound technology improved, ultrasound-guided interventions have been expanding their territory to deeper structures. Ultrasound guidance provides many benefits including protecting vascular injection, shortening procedure time in some cases, and reducing the emission of radiation. In this report, we describe a successful case of a US-guided LSGB without major complications. We expect that US-guided LSGBs can be implemented and furnished in the daily outpatient clinical setting by highly trained pain physicians.
Fluoroscopy ; Ganglia, Sympathetic ; Humans ; Neuralgia ; Outpatients ; Psoas Muscles ; Ultrasonography

PURPOSE: In most cases, xanthogranulomatous pyelonephritis (XGP) is diffusely or focally enlarged, mimicking a neoplastic process. The purpose of this study was to improve the preoperative diagnosis of this disease. MATERIALS AND METHODS: The clinical characteristics, laboratory and radiological findings, preoperative diagnoses and operative methods of 13 patients with XGP, who underwent an operation between 1979 and 2004, were retrospectively reviewed. All patients had undergone intravenous pyelography(IVP) and ultrasonography. Their mean age was 51+/-3.3 years (range 30 to 71), with a male to female ratio of 4 to 9. RESULTS: All 13 patients had flank pain, 8(61.5%) had a urinary tract infection and 9(69.2%) with benign renal disease preoperatively underwent a simple nephrectomy. Four patients preoperatively diagnosed with a renal cell carcinoma(RCC) underwent a radical nephrectomy. 3 patients had extended to the psoas muscle. On the basis of the ultrasonographic features: (1) 6(46.1%) were diffuse hydronephrotic; (2) 4(30.8%) were diffuse parenchymal; (3) 2(15.4%) were diffuse contracted, and (4) 1(7.7%) was segmental or focal. On the basis of the computed tomography(CT) features, the diffuse or global forms(88.9%) were more common than the localized or focal forms(11.1%). Diffuse XGP may be staged as follows: Stage I(25%), involvement is limited to the kidney; Stage II(50%), involvement extends to the perirenal fat within Gerota's fascia; Stage II(25%), involvement extends beyond the Gerota's fascia into another organ. CONCLUSIONS: Preoperative diagnosis of XGP will be raised through a better understanding of the characteristics and radiological findings of this disease.
Diagnosis ; Fascia ; Female ; Flank Pain ; Humans ; Kidney ; Male ; Nephrectomy ; Psoas Muscles ; Pyelonephritis, Xanthogranulomatous* ; Retrospective Studies ; Ultrasonography ; Urinary Tract Infections

Xanthogranulomatous pyelonephritis (XGP) in childhood is not common and the characteristics of the disease are different from those in adults. A 14-year-old boy was admitted to Pusan National University Hospital complaining of fever and right flank pain. An excretory ungraphy shows compressed pelvocalyceal system by extraluminal space occupying lesion in right kidney CT and ultrasonogram of the kidney shows relatively well marinated localized bulging mass on right posterior aspect and invading to the right posterior Gerota's fascia, psoas muscle and quadratus lumborum muscle. Right nephrectomy was performed under the suspicion of Wilms` tumor. Pathologic findings revealed XGP postoperatively. We report a case of focal XGP in a child with review of the literature.
Adolescent ; Adult ; Busan ; Child ; Fascia ; Fever ; Flank Pain ; Humans ; Kidney ; Male ; Nephrectomy ; Psoas Muscles ; Pyelonephritis, Xanthogranulomatous* ; Ultrasonography

No abstract available.
Actinomycosis/*diagnosis/drug therapy/microbiology ; Adult ; Amoxicillin/therapeutic use ; Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Endosonography ; Female ; Gram-Positive Bacteria/isolation & purification ; Humans ; Pancreas/ultrasonography ; Psoas Muscles/ultrasonography ; Tomography, X-Ray Computed

Retroperitoneal Hematoma is a rare intraabdominal bleeding occurring in patients with low- molecular weight heparin anti-coagulant therapy. We report a case of dalteparin sodium-associated retroperitoneal hematoma in a 70-year-old man with diabetic nephropathy with review of this condition in the literature. He had been suffered from type 2 diabetes mellitus and hypertension for 15 years. In July 2002, he was admitted to our hospital because of unstble angina and left pleural effusion. He was treated with dalteparin sodium and aspirin for unstable angina. On the second hospital day, he was refered to division of nephrology for diabetic nephropathy. Laboratory data on admission included white blood cell count of 4,500/mm3, hemoglobin 9.6 g/dL, platelet count 294,000/mm3, BUN 58.1 mg/dL, serum creatinine 4.1 mg/dL, blood glucose 178 mg/dL, hemoglobin A1c 5.9%, PT 13.9 sec (INR: 1.09), and aPTT 50 sec. On days 6 through 8, he had lower back pain, lower extremity pain and neuropathy, anemia and hypotension. Abdominal ultrasound showed 6 x 6 cm-sized well marginated mixed echogenic lesion in psoas muscle and fluid collection in retroperitoneal cavity. Magnetic resonance imaging (MRI) showed increased signal intensity and thickening of the right psoas muscle including 4.7 x 2.3 x 2.1 cm-sized cytic lesion and 6.2X5.3X3.7 cm-sized cystic lesion on the lateral portion of right psoas muscle in T2-weighted images. Percutaneous drainage of cystic lesion was performed by right lateral approach. Hemodialysis was begun without heparinization. Abdominal CT showed 5.5X5 cm-sized high attenuated lesion in right psoas muscle and 5X3 cm, 3X2 cm, 4.5 x 2.5 cm, 4 x 2.5 cm-sized heterogenous, slightly high attenuated lesions in the right lower abdomen and cul-de-sac in the scans with no enhancement. He was treated by conservative therapy. He recovered gradually. Patients with kidney diseases receiving low molecular weight heparin (dalteparin, enoxaparin, etc.) should be closely monitored to prevent serious bleeding complications. The possibility of retroperitoneal hematoma should be considered, whenever symptoms including lower back pain, inguinal pain, leg pain, anemia, or hypotension occured during the lower molecular weight heparin anticoagulant therapy. To our knowledge, this is the first reported case of retroperitoneal hematoma in a patient during dalteparin sodium (Fragmin(R)) anticoagulant therapy.
Abdomen ; Aged ; Anemia ; Angina, Unstable ; Aspirin ; Blood Glucose ; Creatinine ; Dalteparin* ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies* ; Drainage ; Enoxaparin ; Hematoma* ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension ; Hypotension ; Kidney Diseases ; Leg ; Leukocyte Count ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Molecular Weight ; Nephrology ; Platelet Count ; Pleural Effusion ; Psoas Muscles ; Renal Dialysis ; Tomography, X-Ray Computed ; Ultrasonography