Nefrolitiasis

Descripción General

Definición

La nefrolitiasis (también conocida como cálculos renales, urolitiasis o cálculos urinarios) es la formación de piedras en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cualquier parte del tracto urinario.

Clasificación

Existen 5 tipos principales de cálculos renales:

• Cálculo de oxalato de calcio:
  • Representa el 75% de todos los LOS Neisseria cálculos renales (el tipo más común)
  • Cristales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de sobre o de mancuerna
• Cálculo de ácido úrico:
  • Representa el 10% de todos los LOS Neisseria cálculos renales
  • Cristales romboides o en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de roseta
• Cálculo de estruvita (fosfato de amonio y magnesio):
  • Representa el 5%–10% de todos los LOS Neisseria cálculos renales
  • Cristales con forma de tapa de ataúd
• Cálculo de fosfato de calcio:
  • Representa el 5% de todos los LOS Neisseria cálculos renales
  • Prismas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de cuña
• Cálculo de cistina:
  • Representa < 5% de los LOS Neisseria cálculos renales
  • Cristales hexagonales
  • Mnemotecnia: Pronuncie los cálculos de cistina como cálculos de “sixtina” (cálculos de seis lados) para recordar su forma.

Epidemiología

• Es más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hombres que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres
• Es más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hombres blancos no hispanos
• Incidencia pico: 45-70 años, pero puede ocurrir a cualquier edad
• La prevalencia aumenta con la edad.

Etiología

El material normalmente soluble sobresatura la orina y da comienzo la formación de cristales.

Factores de riesgo:

• Historia familiar
• Condiciones médicas:
  • Infecciones del tracto urinario (ITU)
  • Cistinuria
  • Gota (ácido úrico elevado)
  • Hiperparatiroidismo (niveles altos de calcio)
  • Hipertensión
  • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus
  • Enfermedad intestinal inflamatoria
  • Síndrome del intestino corto
• Dieta:
  • Alto contenido de sodio: disminución de la reabsorción de sodio y calcio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo proximal → hipercalciuria
  • Alto contenido de calcio
• Deshidratación: provoca una concentración excesiva de solutos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina → formación de cálculos
• Diuréticos de asa ASA Anterior Cord Syndrome: inhiben la reabsorción de calcio → hipercalciuria

Fisiopatología

Cálculos de oxalato de calcio

• Hipercalciuria normocalcémica idiopática (la causa más común)
• Ingesta de etilenglicol (anticongelante):
  • El etilenglicol es metabolizado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum oxalato por la alcohol deshidrogenasa y la aldehído deshidrogenasa.
  • El oxalato filtrado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina se une al AL Amyloidosis calcio urinario produciendo cristales de oxalato de calcio.
• Disminución del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance urinario:
  • El exceso de iones H⁺ se une al AL Amyloidosis citrato, lo que resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hipocitraturia.
  • El calcio urinario ya no puede unirse al AL Amyloidosis citrato y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum su lugar se une al AL Amyloidosis oxalato, produciendo cristales de oxalato de calcio.
• Ingesta excesiva de vitamina C (ácido ascórbico): disminuye el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de la orina dando lugar a cristales de oxalato de calcio
• Enfermedad de Crohn o resección del intestino delgado:
  • Disminución de la absorción de grasas debido a una mucosa lesionada (enfermedad de Crohn) o a una superficie reducida (resección del intestino delgado)
  • El calcio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lumen gastrointestinal se une a la grasa, lo que provoca un aumento de la absorción de oxalato libre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tracto gastrointestinal.
  • El oxalato filtrado a través de los LOS Neisseria glomérulos se une al AL Amyloidosis calcio urinario, produciendo cristales de oxalato de calcio.

Cálculos de ácido úrico

• Disminución del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de la orina:
  • El exceso de H⁺ se une al AL Amyloidosis urato y forma ácido úrico.
  • Las moléculas de ácido úrico se unen para formar cristales de ácido úrico.
• Clima árido:
  • La sudoración excesiva provoca una depleción de volumen.
  • La depleción de volumen concentra la orina, lo que permite que las moléculas de ácido úrico se unan y formen cristales.
• Hiperuricemia: Los LOS Neisseria cristales de ácido úrico se forman por un aumento del ácido úrico filtrado.
• Aumento del recambio celular (e.g., linfoma, leucemia):
  • La degradación de las purinas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el núcleo celular produce ácido úrico.
  • El exceso de ácido úrico se filtra a través de los LOS Neisseria glomérulos y forma cristales de ácido úrico.

Cálculos de estruvita

• ITU con bacterias ureasa-positivas
• La ureasa degrada la urea Urea A compound formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. Urea Cycle en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum amoníaco y CO_2.
• El amoníaco se une al AL Amyloidosis magnesio y al AL Amyloidosis fosfato formando cálculos de estruvita.
• Bacterias comúnmente implicadas:
  • Staphylococcus saprophyticus Staphylococcus saprophyticus A species of gram-positive bacteria in the family staphylococcaceae. It commonly causes urinary tract infections in humans. Staphylococcus
  • Klebsiella pneumoniae Klebsiella Pneumoniae Gram-negative, non-motile, capsulated, gas-producing rods found widely in nature and associated with urinary and respiratory infections in humans. Aminoglycosides
  • Proteus mirabilis Proteus mirabilis A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is frequently isolated from clinical specimens. Its most common site of infection is the urinary tract. Proteus

Cálculos de fosfato de calcio

• El aumento del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance urinario da lugar a niveles elevados de aniones de fosfato monohidrógeno.
• El fosfato monohidrógeno se une al AL Amyloidosis calcio formando cristales de fosfato de calcio.

Cálculos de cistina

• Cistinuria: defecto autosómico recesivo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cotransportador de sodio-aminoácidos dibásicos
• Resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una disminución de la reabsorción tubular de cistina, ornitina, arginina y lisina
• Las moléculas de cistina se retienen en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina, se unen y forman cálculos de cistina.

Descripción general

Sitios de obstrucción y complicaciones

• Los LOS Neisseria cálculos renales pueden alojarse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cualquiera de los LOS Neisseria tres estrechamientos naturales del uréter:
  • Unión ureteropélvica (unión de la pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy renal y el uréter)
  • Uréter en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la entrada de la pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy (sitio de cruce ureteral de los LOS Neisseria vasos ilíacos)
  • Unión ureterovesical (unión del uréter y la vejiga urinaria)
• Un cálculo alojado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cualquiera de las 3 localizaciones puede causar obstrucción y las consiguientes complicaciones proximales:
  • Pielonefritis aguda:
    • Obstrucción del tracto urinario, que permite el crecimiento proximal de bacterias
    • Inflamación de la pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy renal (y, como resultado, del parénquima renal)
    • Se presenta con fiebre, aumento de la frecuencia urinaria, urgencia, disuria y sensibilidad del ángulo costovertebral
  • Hidronefrosis:
    • La obstrucción provoca la acumulación proximal de orina.
    • Produce la dilatación de la pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy renal y de los LOS Neisseria cálices (visible en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el ultrasonido)

Presentación Clínica y Diagnóstico

Presentación clínica

• Depende del tamaño, número y localización de los LOS Neisseria cálculos
• Los LOS Neisseria cálculos pequeños pueden ser asintomáticos.
• Los LOS Neisseria cálculos dentro de la pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy renal y la vejiga suelen ser asintomáticos.
• Los LOS Neisseria síntomas suelen estar asociados a una obstrucción ureteral aguda:
  • Dolor Dolor Inflammation abdominal unilateral de tipo cólico debido a un peristaltismo ureteral intermitente:
    • El dolor Dolor Inflammation de tipo cólico se irradia a la ingle, los LOS Neisseria testículos o los LOS Neisseria labios mayores
    • Causa sensibilidad en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el ángulo costovertebral
    • Por lo general, se asocia con incapacidad para quedarse quieto
  • Hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma por traumatismo del uréter (franca o microscópica)
  • Náuseas y/o vómitos
  • La fiebre sugiere una infección asociada o una pielonefritis.

Diagnóstico

Imagenología:

• TC de abdomen y pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy sin contraste:
  • Es el estándar de oro de imagenología para los LOS Neisseria cálculos renales
  • Puede mostrar la localización y el tamaño del cálculo
  • Puede detectar hidronefrosis
• Ultrasonido abdominal: se utiliza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres embarazadas y niños para evitar la radiación
• Radiografía abdominal: puede detectar los LOS Neisseria cálculos grandes

Estudios de laboratorio:

• Análisis de orina y tira reactiva de orina:
  • Útil para detectar la hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma microscópica
  • Determina el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance urinario y ayuda a determinar el tipo de cálculo
• Microscopía de orina: evalúa la forma de los LOS Neisseria cristales

Tratamiento

Enfoque basado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tamaño

• < 5 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma: solo observación (el pasaje espontáneo es probable)
• 5-10 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma: alfa-bloqueantes o bloqueadores de los LOS Neisseria canales de calcio dihidropiridínicos
• 10-20 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma: litotricia extracorpórea por ondas de choque o ureterorrenoscopia
• > 20 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma: nefrolitotomía percutánea

Tratamiento médico

Cuidados generales de soporte:

• Hidratación con líquidos intravenosos
• Medicamentos analgésicos (el dolor Dolor Inflammation puede ser intenso)
• Alfa-bloqueantes (e.g., terazosina, tamsulosina) o bloqueadores de los LOS Neisseria canales de calcio dihidropiridínicos (e.g., nifedipina) para dilatar y relajar los LOS Neisseria uréteres y permitir el paso de cálculos < 10 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma

Tratamiento específico del cálculo:

• Cálculos de oxalato de calcio y fosfato de calcio:
  • Dieta baja en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sodio para aumentar la reabsorción concomitante de sodio y calcio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria túbulos proximales
  • Citrato para disolver los LOS Neisseria cristales de oxalato de calcio
  • Diuréticos tiazídicos para aumentar la reabsorción de calcio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo distal
• Cálculos de estruvita: terapia antibiótica para eliminar el microbio causal
• Cálculos de ácido úrico:
  • Alcalinización de la orina con citrato de potasio para disolver los LOS Neisseria cristales de ácido úrico
  • Alopurinol para disminuir la producción de ácido úrico
• Cálculos de cistina: tiopronina o penicilamina para quelar la cistina

Tratamiento quirúrgico

• Litotricia extracorpórea por ondas de choque:
  • Fragmentación del cálculo con ondas sonoras
  • No se realiza de forma rutinaria en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes obesos debido a la escasa penetración de las ondas sonoras
• Ureterorenoscopia: procedimiento endoscópico transuretral para visualizar todo el tracto urinario y extraer el cálculo renal
• Nefrolitotomía percutánea: procedimiento quirúrgico con incisión en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la piel para extraer el cálculo renal

Prevención

• Hidratación adecuada
• Dieta baja en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sodio y proteínas

Diagnóstico Diferencial

• Apendicitis aguda: inflamación del apéndice causada por la impactación de un fecalito en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adultos, o por una hiperplasia linfoide en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños. La presentación inicial es un dolor Dolor Inflammation periumbilical difuso, que luego se localiza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuadrante inferior derecho. En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cambio, la nefrolitiasis provoca dolor Dolor Inflammation de costado. El diagnóstico de la apendicitis es principalmente clínico y el tratamiento es una apendicectomía.
• Torsión testicular: la torsión del cordón espermático causada por el aumento de la movilidad testicular en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la bolsa escrotal. La presentación incluye eritema, hinchazón, ausencia de reflejo cremastérico y dolor Dolor Inflammation testicular intenso de aparición repentina. Por el contrario, el dolor Dolor Inflammation inducido por la nefrolitiasis se origina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el flanco y posteriormente se irradia a la ingle. El diagnóstico de la torsión testicular se realiza mediante ultrasonido Doppler Doppler Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. Ultrasound (Sonography). El tratamiento es manual, o la detorsión quirúrgica con orquiopexia bilateral.
• Cólico biliar: un dolor Dolor Inflammation de tipo cólico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuadrante superior derecho, causado por la obstrucción intermitente del conducto cístico por un cálculo biliar. La presentación es un dolor Dolor Inflammation episódico, especialmente después de la ingesta de una comida grasa. Por el contrario, el dolor Dolor Inflammation debido a la nefrolitiasis no está relacionado con la alimentación. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la combinación de los LOS Neisseria signos clínicos y los LOS Neisseria hallazgos del ultrasonido del cuadrante superior derecho. A menos que el paciente desarrolle una colecistitis aguda, el tratamiento es la observación.
• Diverticulitis Diverticulitis Inflammation of a diverticulum or diverticula. Diverticular Disease: inflamación de los LOS Neisseria divertículos causada por la impactación de un fecalito. La presentación puede incluir dolor Dolor Inflammation en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuadrante inferior izquierdo, fiebre de moderada a alta y heces sanguinolentas. En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cambio, la nefrolitiasis no se caracteriza por la presencia de heces sanguinolentas. La diverticulitis Diverticulitis Inflammation of a diverticulum or diverticula. Diverticular Disease se diagnostica con una TC del abdomen y la mayoría de los LOS Neisseria casos se tratan con antibióticos intravenosos.