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[Intermittent flank pain]
A Beganović1, B P J van Bezooijen, B G F Heggelman
1Westfriesgasthuis, afd. Chirurgie, Hoorn. a.beganovic@westfriesgasthuis.nl
Nederlands Tijdschrift Voor Geneeskunde
|September 24, 2008
Summary
Intermittent flank pain can stem from rare causes like crossing accessory renal vessels causing ureteropelvic junction obstruction. Prompt imaging during symptomatic episodes is key for timely diagnosis and treatment of this condition.
Area of Science:
- Urology
- Nephrology
- Diagnostic Imaging
Background:
- Flank pain is a frequent clinical presentation with diverse etiologies.
- Ureteropelvic junction (UPJ) obstruction is a recognized cause of flank pain, often congenital.
- Accessory renal vessels are common anatomical variations, typically asymptomatic.
Observation:
- Two patients presented with recurrent, intermittent flank pain.
- The pain episodes correlated with temporary obstruction at the ureteropelvic junction.
- Diagnostic challenge was posed by the intermittent nature of the symptoms.
Findings:
- The unusual cause of intermittent UPJ obstruction was identified as crossing accessory renal vessels.
- These vessels impinged upon the renal pelvis or proximal ureter during specific physiological states.
- This mechanical obstruction led to the characteristic flank pain.
Implications:
- Highlights a rare but significant cause of intermittent flank pain.
- Emphasizes the importance of dynamic imaging during symptomatic periods for accurate diagnosis.
- Suggests that understanding vascular anatomy is crucial in evaluating complex flank pain cases.
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