Upper Urinary Tract Causes of Hematuria

Published on 22/03/2015 by admin

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Last modified 22/03/2015

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Chapter 513 Upper Urinary Tract Causes of Hematuria

513.6 Vascular Abnormalities

Hemangiomas, hemangiolymphangiomas, angiomyomas, and arteriovenous malformations of the kidneys and lower urinary tract are rare causes of hematuria. They can manifest with microscopic hematuria or gross hematuria with clots. Cutaneous vascular malformations, when present, can offer a clue to these underlying causes of hematuria. Renal colic can develop if the upper tract is involved. The diagnosis may be confirmed by angiography or endoscopy.

Unilateral bleeding of varicose veins of the left ureter, resulting from compression of the left renal vein between the aorta and superior mesenteric artery (mesoaortic compression), is referred to as the nutcracker syndrome. Patients with this syndrome typically present with persistent microscopic hematuria (occasionally, recurrent gross hematuria) that may be accompanied by proteinuria, lower abdominal pain, flank pain, or orthostatic hypotension. Diagnosis is confirmed by Doppler ultrasonography, CT, phlebography of the left renal vein, or magnetic resonance angiography.