Stone-containing urachal cysts are extremely rare in adults. Here, we report the case of a 58-year-old man with a urachal cyst who had lower abdominal pain and urinary frequency. Abdominal ultrasonography and computed tomography showed hyperdense stones in the urachus. He was treated with a laparoscopic excision using a transperitoneal approach. The pathological diagnosis was an inflammed urachal cyst. This rare case illustrates an inflammed urachal cyst containing stones treated with laparoscopy.
Humans ; *Laparoscopy ; Male ; Middle Aged ; Urachal Cyst/pathology/radiography/*surgery ; Urinary Bladder Calculi/pathology/radiography/*surgery

Twenty-four anatrophic nephrolithotomies under hypothermia were performed between June, 1980, and July, 1982, to remove staghorn and multiple renal calculi. 1. There were no operative deaths, and eight transient postoperative complications occurred. These complications resolved during their initial hospitalization, and no nephrectomies were required. 2. The average time of the operation was 4.17 hours, and the mean cold renal ischemic time was 51 minutes. The patient required an average of 1.9 pints of blood intraoperatively and no transfusion postoperatively. The average length of postoperative hospitalization was 10.3 days in all patients and 17.4 days in complicated cases. 3. Magnesium ammonium phosphate calculi were present in the major of patients (62.5%) in staghorn calculi and calcium oxalate (62.5%) in multiple renal calculi. 4. Postoperative evaluation was done in 16 of 24 patients. Seven patients (43.8%) has residual calculi. This high residual stone rate was due to lack of intraoperative roentgenography. 5. Among 16 patients, 9 had preoperative urinary tract infection. In 4 patients who had residual stone, 2 patients had perpetuated urinary tract infection and in 5 patients who had no residual stone, postoperative urine culture were sterile. 6. Intravenous pyelography was performed 3 months after the operation in 6 patients. Of these 6 patients 5 revealed stable or improved renal function. In 1 patient it revealed non-functioning kidney. We suppose it may be due to vascular spasm or injury.
Ammonium Compounds ; Calcium Oxalate ; Calculi ; Hospitalization ; Humans ; Hypothermia* ; Kidney ; Kidney Calculi ; Magnesium ; Nephrectomy ; Postoperative Complications ; Radiography ; Spasm ; Urinary Tract Infections ; Urography

A 74-yr-old woman presented with fever and abdominal discomfort. She was in a septic condition caused by urinary tract infection. Her computed tomogram of the abdomen revealed features of hydronephrosis with ureteral stones in both kidneys. During percutaneous nephrostomies, right pyeloduodenal fistula (PDF) was diagnosed. Elective surgery was originally planned but the patient was in a poor condition to undergo surgery. Instead, 2 times endoscopic clipping and ligation by endoloop were applied with parenteral antibiotics for the fistula lesion. On admission day 30, she was discharged from the hospital after confirmation of no more contrast leakage on fistulography. We reviewed the literature and discuss the etiologies, clinical presentations, diagnosis, and treatment of PDF.
Aged ; Duodenal Diseases/complications/radiography/*surgery ; Female ; Humans ; Hydronephrosis/complications/radiography ; Intestinal Fistula/complications/radiography/*surgery ; Kidney/radiography/surgery ; Kidney Calculi/complications/radiography ; Kidney Diseases/complications/radiography/*surgery ; Ligation ; Urethral Obstruction/complications/radiography ; Urinary Fistula/complications/radiography/*surgery ; Urinary Tract Infections/complications/radiography

PURPOSE: To evaluate the efficacy of low-dose computed tomography (LDCT) for detecting urinary stones with the use of an iterative reconstruction technique for reducing radiation dose and image noise. MATERIALS AND METHODS: A total of 101 stones from 69 patients who underwent both conventional nonenhanced computed tomography (CCT) and LDCT were analyzed. Interpretations were made of the two scans according to stone characteristics (size, volume, location, Hounsfield unit [HU], and skin-to-stone distance [SSD]) and radiation dose by dose-length product (DLP), effective dose (ED), and image noise. Diagnostic performance for detecting urinary stones was assessed by statistical evaluation. RESULTS: No statistical differences were found in stone characteristics between the two scans. The average DLP and ED were 384.60+/-132.15 mGy and 5.77+/-1.98 mSv in CCT and 90.08+/-31.80 mGy and 1.34+/-0.48 mSv in LDCT, respectively. The dose reduction rate of LDCT was nearly 77% for both DLP and ED (p<0.01). The mean objective noise (standard deviation) from three different areas was 23.0+/-2.5 in CCT and 29.2+/-3.1 in LDCT with a significant difference (p<0.05); the slight increase was 21.2%. For stones located throughout the kidney and ureter, the sensitivity and specificity of LDCT remained 96.0% and 100%, with positive and negative predictive values of 100% and 96.2%, respectively. CONCLUSIONS: LDCT showed significant radiation reduction while maintaining high image quality. It is an attractive option in the diagnosis of urinary stones.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Urinary Calculi/*radiography ; Young Adult

PURPOSE: To evaluate the efficacy of low-dose computed tomography (LDCT) for detecting urinary stones with the use of an iterative reconstruction technique for reducing radiation dose and image noise. MATERIALS AND METHODS: A total of 101 stones from 69 patients who underwent both conventional nonenhanced computed tomography (CCT) and LDCT were analyzed. Interpretations were made of the two scans according to stone characteristics (size, volume, location, Hounsfield unit [HU], and skin-to-stone distance [SSD]) and radiation dose by dose-length product (DLP), effective dose (ED), and image noise. Diagnostic performance for detecting urinary stones was assessed by statistical evaluation. RESULTS: No statistical differences were found in stone characteristics between the two scans. The average DLP and ED were 384.60+/-132.15 mGy and 5.77+/-1.98 mSv in CCT and 90.08+/-31.80 mGy and 1.34+/-0.48 mSv in LDCT, respectively. The dose reduction rate of LDCT was nearly 77% for both DLP and ED (p<0.01). The mean objective noise (standard deviation) from three different areas was 23.0+/-2.5 in CCT and 29.2+/-3.1 in LDCT with a significant difference (p<0.05); the slight increase was 21.2%. For stones located throughout the kidney and ureter, the sensitivity and specificity of LDCT remained 96.0% and 100%, with positive and negative predictive values of 100% and 96.2%, respectively. CONCLUSIONS: LDCT showed significant radiation reduction while maintaining high image quality. It is an attractive option in the diagnosis of urinary stones.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Urinary Calculi/*radiography ; Young Adult