case_images: PMC10710362_01
case_images: Case 1 EKG (at admission). EKG identified sinus tachycardia and diffuse ST segment depression.
case_images: CRIU2023-8901383.001.jpg
case_images: PMC10710362_01_CRIU2023-8901383.001.jpg
case_images: fig1
case_images: EKG identified sinus tachycardia and diffuse ST segment depression, as can be analyzed in Figure 1.
case_images: Case 1 thoracoabdominopelvic CT scan (at admission). CT scan revealed an incomplete staghorn calculus measuring 26*14 mm impacted in the right pyelo-junction inducing hydronephrosis (a, e) and signs compatible with xanthogranulomatous pyelonephritis (a, c-e). A solid and heterogeneous right adrenal mass of 60*55*62 mm can also be identified (b).
case_images: CRIU2023-8901383.002.jpg
case_images: PMC10710362_01_CRIU2023-8901383.002.jpg
case_images: fig2
case_images: CT images are depicted in Figure 2.
case_images: Case 1 clinical and analytical evolution. Case 1 analytical evolution of cardiac necrosis markers and inflammatory markers. The patient was under ECMO between the 2nd and 10th days, hemodialysis between the 2nd and 12th days, and mechanical ventilation until the 8th day. She was treated with 14 days of effective antibiotic therapy 2 days of piperacillin and tazobactam and 12 days of amoxicillin/clavulanate. BNP: B natriuretic peptide; CK-MB: creatine kinase-myocardial band; CRP: C-reactive protein; Leuk: leucocytes. In the first days in the ICU, two blood sample analyses were performed daily, which are depicted in the graph as morning (*) and evening (**). For graphical coherence, the troponin and myoglobin level scale is at a tenth of the real value.
case_images: CRIU2023-8901383.003.jpg
case_images: PMC10710362_01_CRIU2023-8901383.003.jpg
case_images: fig3
case_images: Clinical evolution and analytical results can be found schematically in Figure 3.
case_images: Case 1 abdominopelvic CT scan (after flexible RIRS with thulium laser). The CT scan shows residual lithiasis of small size (including intraparenchymal stones) and a double J stent.
case_images: CRIU2023-8901383.004.jpg
case_images: PMC10710362_01_CRIU2023-8901383.004.jpg
case_images: fig4
case_images: After 3 months, the patient was submitted to retrograde intrarenal surgery (RIRS) with thulium laser stone fragmentation in two sessions with an excellent postoperative result, as can be confirmed by the CT images available in Figure 4.
case_images: PMC10710362_02
case_images: Case 2 abdominopelvic CT scan (at admission). The CT scan shows a 72*66 mm bilobate mass of the right adrenal gland in coronal (a) and transverse (b) views.
case_images: CRIU2023-8901383.005.jpg
case_images: PMC10710362_02_CRIU2023-8901383.005.jpg
case_images: fig5
case_images: CT scan revealed a 72*66 mm bilobate mass of the right adrenal gland. CT images are reproduced in Figure 5.
case_images: Case 2 clinical and analytical evolution. Case 2 analytical evolution of cardiac necrosis markers. The patient was under mechanical ventilation until the 5th day and between the 5th and 7th day under noninvasive ventilation. CK-MB: creatine kinase-myocardial band; NIV: noninvasive ventilation. In the first days in the ICU, two blood sample analyses were performed daily, which are depicted in the graph as morning (*) and evening (**). For graphical coherence, troponin and myoglobin level scale is at a tenth of the real value.
case_images: CRIU2023-8901383.006.jpg
case_images: PMC10710362_02_CRIU2023-8901383.006.jpg
case_images: fig6
case_images: Clinical evolution and analytical results can be found schematically in Figure 6.