I am a nursing student working on a case study and don't understand the relationship of a disease process. My patient is a 57 yr. old male diagnosed with advanced colorectal cancer with metastasis to the lungs. He first presented severly anemic (Hg of 5.5, Hct of 9, BUN of 20, creatinine of 1.66, albumin of 3.4, sed rate of 60, CEA of 128), 3+ pitting edema on both lower extremities with seeping lesions, grossly edematous scrotal area, diffused ascities, 25lb. weight loss, poor appetite, urinating from his rectum, and in an extreme amount of pain. I understand he has a vesicocolonic fistula which is why he urinates from his rectum and I understand all the other disease processes that accompany this type of cancer but I do not understand his CT report.
His CT scan showed "The urinary bladder as unrevealing. There is a moderate amount of stool; 3x3mm calcifications found in the lower pole of the left kidney. The left kidney appears hypertrophied and the right is hypoplastic."
Hypertrophy means under developed and hypoplastic is enlarged so was he born with one under developed kidney and the other was enlarged due to compensation? Or did the cancer metastasize to the left kidney causing it to hypertrophy? Are 3x3mm stones big enough to cause a blockage? When the CT report says a moderate amount of stool, do they mean in the kidney (It is not specified within the report)? Please post your thoughts as I am a little lost on this one...Thank you!
Actually Hypertrophy is enlarged and atrophy is shrunken, therefore the left kidey is the large one and likely compensating for the right kidney. If the kidney is globally enlarged (as opposed to a discreet area or mass) then it is likely compensation hypertrophy as it doing the work of both kidneys and not a Met. 3 mm calcifaction is quite small and in the lower pole unlikely to cause a blockage. If it were to migrate into the ureter it can cause a blockage, but it is of a size that he can pass as well. The stool is usually referring to the colon and rectum not the kidney.
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