Urinary Bladder Stones in Aboriginal Children

Iv!ediccd

Brit. Med.

284: 405-406 (Feb. 6) 1982

The authors report on an infant with calcification of the bladder associated with the administration of sodium bicarbonate and calcium chloride through a misplaced umbilical catheter. The peripheral distribution of calcification and the occurrence of a u:rachal fistula in the patient suggested to the authors that the umbilical catheter was inadvertently passed alongside the urachus rather than into an umbilical artery, which would have led to full thickness damage of the bladder wall. Because of the fast resorption of the calcium and return of contractility the prognosis for normal bladder function was encouraging but the infant may have residual upper urinary tract damage. The location of the umbilical catheter should be checked by successful draining back of blood before injection, and the catheter should be flushed with saline when sodium bicarbonate and calcium chloride are to be given in quick succession. G.P.M. 2 figures, l reference

as :rnueh as vertsbrae apHrt. The 2.uthcrts desc::dbed a case of a renal artery '"''"'°'"""'¾ above the celiac axis at the level of the eleventh. thoracic vertebra. It was an incidental finding, noted the evaluation of a woman for hypertension. The authors discussed the <>n,h·nu,. genesis of this anomaly and mentioned that this anomalous high renal artery results from a persistence of primitive cranial mesonephric vessels. A normal kidney urographicaHy with no apparent blood supply on aortog-.raphy should alert for a search of high and low ectopic renal artery since the aorta at the level of the eleventh thoracic vertebra often is not visualized routinely. The demonstration of anomalous renal arteries is important to avoid lacerations during renal operation and also to evaluate the suitability of the renal donor for renal transplantations. N. V. R. 2 figures, 5 references

Unilateral Adrenal Catecholamine Excess. Pheochromocytoma or Possible Sporadic Medullary Hyperplasia A.

Urinary Bladder Stones in Aboriginal Children Z. S.

WISNIEWSKI,

J. G. BROCKIS AND G.D. Perth HlJNJtU.1:t, and Western Australia

RYAN,

Department Sur-

!"ll"'lTmmr

Aust. New Zeal. J. Surg., 51: 292-295 (June) 1981 From 1970 to 1979, 10 aboriginal children were treated for vesical calculus, all of whom had infected urine. The major constituents of the stones were ammonium, calcium, urate and oxalate ions, but calcium and magnesium ammonium phosphates also were found. Aboriginal children are breast fed and this breast feeding continues until they are 2 years old. The only dietary supplement is a mixture of white flour and water. Urinary ammonium ion concentration in children fed a milk and cereal diet is high, and it is postulated that the formation of ammonium acid urate may precipitate the calculus formation with other ions added subsequently. The low urinary volumes in the children studied indicate that dehydration is common in those children who reside in a hot climate (35 to 40C). D. K. M . 5 tables, 15 references

DISEASES OF' BLOOD HYPERTENSION .A.1'.TD RENOV ASCULAR SURGERY Renal

R.

BAUMAN, Section of Endocrinology, Department Medicine, Montefiore Hospital and Medical Center, Bronx, New York, and White Plains Hospital Medical Center, White Plains, New York

Arch. Intern. Med., 142: 377-378 (Feb.) 1982 This author reports on a man with a 5-year history of paroxysmal hypertension and episodes of tachycardia and svveating, h<>~<,rnc,,,,-,,.~ responses to IJHCWJA' and propranolol were observed. Venous blood from the left adrenal gland had concentrations of norepinephrine, epinephrine and dopamine that were 27, 101 and 135-fold higher than the venous blood from the right adrenal gland. A preoperative diagnosis of pheochromocytoma was made but attempts to localize the lesion by excretory urography, ultrasonography and computerized axial tomography of the abdomen were unsuccessful. At surgical exploration venous blood was collected from the adrenal veins and from the inferior vena cava. Once again, elevations of norepinephrine, epinephrine and dopamine were found in the venous blood from the left adrenal gland. Total left ad.renalectomy was performed. Pathological examination revealed a weight of 9 gm. (normal weight 5 The adrenal cortex was u~»nuu. of the medulla was replaced blood and ,rnsw.LJ..J.,s., cells were seen. ~~.CWSUHHRC

ical examination was unable to confirm a u11c1grws:1E author believes that either 1.mv~·~'h"],..2n'':"",,.-ce,-~.,-~-- or adrenal medhyperplasia was the cause of the symptoms . .D. K. M. 2 tables, 9 :references

Originating Above Celiac Axis

D. H. GORDON AND S. GLANZ, Department Radiology, Division Cardiovascular Radiology, State University of New York-Downstate Medical Center, Brooklyn, New York

Unilateral Renal Vein Thrombosfa Withm.1.t Protei:mxria

SCHAFFER,

N. Y. State J. Med., 81: 1109-1111 (June) 1981 Renal arteries normally take origin from the aorta between the first and second lumbar segments, usually at the level of the first and second lumbar interspaces. Deviations in the level of origin of approximately 1 vertebral body in either direction are seen commonly. In 25 per cent of the patients they may

D. G.

SAPIR, J. E. MOULSDALE AND J. M. LJHnmJl'.,fi!n.M." Department of Medicine, Johns Hopkins University School of Medicine, and Departments of Medicine and Surgery, Church Hospital, Baltimore, Maryland

Amer. J. Med. Sci., 283: 89-93 (Mar./ Apr.) 1982 Renal vein thrombosis is associated with primary renal disease, mechanical factors that produce blood stasis and diseases that cause abnormal blood coagulation. Despite the assertion in a recent review that proteinuria does not invariably accom-