GENITALIA: Normal external male genitalia. Bowel soundsare normal.ĮXTREMITIES: No peripheral edema or varicosities. There is no guarding or rebound tenderness. ABDOMEN: There is slight left flank tenderness to deep palpation. LUNGS: Clear to percussion and auscultation. HEENT: Pupils are equal, round and reactive to light and accommodation. GENERAL: Well-developed, well-nourished white male in no acute distress. VITAL SIGNS: Pulse is 72 and regular, respirations 18 and regular, blood pressure 122/78. Denies emesis, melena, constipation, diarrhea or rectal bleeding. Gastrointestinal: He has occasional indigestion. Cardiorespiratory: Denies shortness of breath, dyspnea on exertion, chest pain, cough or hemoptysis. Musculoskeletal: No muscle or joint pain. REVIEW OF SYSTEMS: Neurologic: Denies vertigo, syncope, convulsions or headaches.
Smokes one pack of cigarettes per day over the last 10 years.įAMILY HISTORY: Father died of cancer, type unknown. Diovan 80 mg with hydrochlorothiazide 12.5 mg daily.ĪLLERGIES: There are no known drug allergies. PAST MEDICAL HISTORY: He had surgery on his right knee two years ago.ġ. The patient is admitted at this time for complete urologic evaluation. He had a right kidney which was malrotated but was otherwise normal. It was suggested that a renal MRI be done for further delineation of this problem. This showed what appeared to be an infarction of an area of the lower pole of the left kidney. The patient subsequently had a CT renal scan with contrast. Urine cytology was negative for malignant cells. There was no evidence of renal or ureteral calculi or hydronephrosis. Intravenous pyelogram was done which demonstrated a low-lying malrotated right kidney. When seen in our office, the patient continued to have mild left flank pain and no difficultly voiding. The patient had a CT stone profile which showed no evidence of renal calculi. HISTORY OF PRESENT ILLNESS: This is a (XX)-year-old white male who went to the emergency room with sudden onset of severe left flank and left lower quadrant abdominal pain associated with gross hematuria.
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