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Abdominal Pain, Blood In Urine. Found Swollen Lymph Node In Abdomen And Kidney Stone. Worrisome

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Posted on Tue, 19 Feb 2013
Question: My 33 year old son has been experienced pain in his lower abdomen and general lethargy for a month or so. He has four very young children experiencing the same ailments common in a young family – colds, stomach viruses etc. and he thought he might be experiencing the lingering effects of back-to-back illnesses associated with those illnesses he and his wife and children had been periodically experiencing. He’s a healthy guy – just recently finished (within 2 months) a 26 mile back-woods marathon. I didn’t know there was such a thing – thought only animals ran in the woods and then only the dumb ones would uninterruptedly run for 26 miles…I digress. On Christmas Eve he started passing blood in his urine, then went to the doctor and was given a blood and urine test. They came back negative. I believe at that time they should have ordered a CT scan to determine if he had a kidney stone, especially since it runs in families and I had one about 30 years ago and required major open surgery to remove it – but that was the more prevalent treatment at that time. Recently his doctor ordered a CT scan and it was determined he did (in fact) have a 10 mm stone lodged in his left kidney. His pain level has been tolerable which leads me to believe the stone is in the kidney (as indicated on CT scan) and not in the urinary tract…yet. He is scheduled to have the stone removed on Tuesday of next week. They will initially try Shock Wave Lithotripsy (ESWL) and seem to be optimistic. The alternative would be Ureteroscopy (URS) followed by Percutaneous nephrolithotomy (PNL). Hopefully, the fourth option, Open surgery will not be required.
HERE IS MY QUESTION. The doctor indicated there was a swelling of the lymph nodes in the abdomen area and has scheduled my son to see a Hematologist-Oncologist the following day. From what I’ve read on the Internet, it seems to be quite common to experience a swelling of the lymph nodes in the area of an infection or obstruction. Since he’s been experiencing pain in this region for over a month and he’s probably had this stone lodged (or forming) in his kidney for that period of time – ISN’T IT LOGICAL TO EXPECT THE LYMPH NODES IN THE AREA TO BE INFLAMED AND SWELLING? I’m an avid advocate of thoroughness and I agree they should follow-up with the necessary test to determine the possible presence of a blood disease…but, I’d like an outside opinion/explanation as to the usualness or unusualness of the follow-up visit (the next day) with the Hematologist-Oncologist. Also, I’m a little confused about the term – “Hematologist-Oncologist”. I thought you were either one of the other.
doctor
Answered by Dr. G.Srinivasan (12 hours later)
Hi,
Welcome to XXXXXXX and thanks for your query.
First I would like to explain the nomenclature of the specialists.
Cardiovascular surgeons/ vascular surgeons- dermatologist/venereologist/ dermato-venereologist are few examples of intersections in medicine.
The main diseases of blood are cancers and hence people who sub-specialize in cancer of the blood are called hemato- oncologists.
So, I would suggest you not to worry of the name and proceed with the treatment options.
Coming to the treatment, 10 mm stone DOES NOT require open surgery.
It needs lithotripsy in usual situations and PCNL in very rare situations.
After seeing enough stone cases, I do not think that the lymph nodes are due to the stone or infection in the kidneys.
It is usually due to chronic inflammation, tuberculosis or a tumor ( primary or secondary).
So I do feel that he needs to be evaluated separately by the hemato- oncologist.
Hope this helps. Kindly write back for doubts if any---
Best regards
DR GS


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. G.Srinivasan (17 minutes later)
Please elaborate a little more on the possible causes for the lymph nodes issue.
I forgot to mention that when my son was a teenager, he experienced three (3) occasions of a collapsed lung – both sides. This occurred over a period of about two years and they eventually "COATED" his lungs to prevent any possibility of collapse in the future. DO YOU THINK THESE OCCURANCES OF A COLLAPSED LUNG AND SUBSEQUENT "COATING" OF BOTH LUNGS COULD HAVE ANYTHING TO DO WITH THE CURRENT CONDITION OF THE SWOLLEN LYMPTH NODES?
doctor
Answered by Dr. G.Srinivasan (3 hours later)
Hi,
Welcome to XXXXXXX
If the collapse was due to tuberculosis, there is a possibility.
Best regards,
DR GS.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. G.Srinivasan

Urologist

Practicing since :1991

Answered : 1412 Questions

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Abdominal Pain, Blood In Urine. Found Swollen Lymph Node In Abdomen And Kidney Stone. Worrisome

Hi,
Welcome to XXXXXXX and thanks for your query.
First I would like to explain the nomenclature of the specialists.
Cardiovascular surgeons/ vascular surgeons- dermatologist/venereologist/ dermato-venereologist are few examples of intersections in medicine.
The main diseases of blood are cancers and hence people who sub-specialize in cancer of the blood are called hemato- oncologists.
So, I would suggest you not to worry of the name and proceed with the treatment options.
Coming to the treatment, 10 mm stone DOES NOT require open surgery.
It needs lithotripsy in usual situations and PCNL in very rare situations.
After seeing enough stone cases, I do not think that the lymph nodes are due to the stone or infection in the kidneys.
It is usually due to chronic inflammation, tuberculosis or a tumor ( primary or secondary).
So I do feel that he needs to be evaluated separately by the hemato- oncologist.
Hope this helps. Kindly write back for doubts if any---
Best regards
DR GS