On presentation these patients are usually commenced on antibiotics as the constellation of symptoms and signs suggests infection. When imaging studies are done, such as CT, the appearances usually suggest the possibility of a renal cell carci-
3. NONTRAUMATIC RENAL EMERGENCIES 43
FIGURE 3.14. A case of xanthogranulomatous pyelonephritis (left) as seen on CT. This can be very difficult to distinguish radiologically from a renal cancer.
noma, and therefore when signs of infection have resolved, the majority of patients will proceed to nephrectomy. Only following pathological examination of the removed kidney will it become apparent that the diagnosis was one of infection (xanthogranu-lomatous pyelonephritis) rather than one of a tumour.
Caro JJ, Trindale E, McGregor M. The risks of death and severe non-fatal reactions with high vs low osmolality contrast media. AJR 1991; 156:825-832.
Holm-Nielsen A, Jorgensen T, Mogensen P, Fogh J. The prognostic value of probe renography in ureteric stone obstruction. Br J Urol 1981; 53:504-507.
Khadra MH, Pickard RS, Charlton M, et al. A prospective analysis of 1,930 patients with hematuria to evaluate current diagnostic practice. J Urol 2000;163:524-527.
Kobayashi T, Nishizawa K, Mitsumori K, Ogura K. Impact of date of onset on the absence of hematuria in patients with acute renal colic. J Urol 2003;1770:1093-1096.
Laerum E, Ommundsen OE, Granseth J, et al. Intramuscular diclofenac versus intravenous indomethacin in the treatment of acute renal colic. Eur Urol 1996;30:358-362.
44 J. REYNARD
Louca G, Liberopoulos K, Fidas A, et al. MR urography in the diagnosis
of urinary tract obstruction. Eur Urol 1999;35:14. Luchs JS, Katz DS, Lane DS, et al. Utility of hematuria testing in patients
with suspected renal colic: correlation with unenhanced helical CT
results. Urology 2002;59:839. O'Malley ME, Soto JA, Yucel EK, Hussain S. MR urography: evaluation
of a three-dimensional fast spin-echo technique in patients with
hydronephrosis. AJR 1997;168:387-392. Segura JW, Preminger GM, Assimos DG, et al. Ureteral Stones Guidelines