Patient Presentation

The patient presentation associated with upper urinary tract obstruction is varied. In addition, the differential diagnosis of upper urinary obstruction is extensive (Table 10.1). Many patients seen on an emergent basis will have classic symptoms of renal colic; however, an urgent evaluation may be requested for a totally asymptomatic patient with incidentally discovered unilateral or bilateral upper urinary tract obstruction.

The presenting signs and symptoms can be impacted by many factors related to the underlying etiology such as the interval of time in which the obstruction developed (acute vs chronic), presence of infection, nature of the obstruction (intrinsic vs extrinsic), laterality (unilateral vs bilateral), and the degree of blockage (complete obstruction vs partial obstruction) (Gulmi et al. 2002). Other important factors to consider when evaluating a patient with upper urinary obstruction are the patient's number of renal moieties, known congenital anomalies of the upper urinary tract (e.g., horseshoe kidney), and a history of renal transplantation. For example, the signs and symptoms for a patient with a blocked renal allograft would be entirely different than a patient with a blocked solitary native kidney. Specifically, pain-related symptoms of obstruction would classically be absent in the renal transplantation patient.

Baby Sleeping

Baby Sleeping

Everything You Need To Know About Baby Sleeping. Your baby is going to be sleeping a lot. During the first few months, your baby will sleep for most of theday. You may not get any real interaction, or reactions other than sleep and crying.

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