Wen or lipoma, appearing in subcutaneous fat.rarely becomes a cause for concern: such tumors do not cause pain, are easily removed, rarely degenerate into malignant ones. But if the adipose begins to form in internal organs, the clinical picture and therapeutic plan will be completely different. You can see this with the example of a kidney lipoma.
Kidney lipid
Renal lipoma is a benign new growth consisting of fat cells of different sizes. According to statistical data, pathology is most common in women aged 40-55 years. But considering the fact that the etiology of the nephrologic lipoma has not been thoroughly studied yet, it is difficult to establish the reasons for getting a particular category of people at risk.
But even if lipoma remains a benign fatty tumor, it can cause serious complications that are dangerous for life and health.
There is a certain gradation in size, allowing to judge whether a small lipoma or large. The established norm of the size of the kidney lobe is up to 4.5 cm. Up to these indices it is considered small, when exceeding this boundary, it is large. More often the lipoma is formed on the left kidney, rather than on the right kidney.
ICD-10 assigned the lipoma code of D-17 disease.
Causes and pathogenesis of
The etiology of the disease so far belongs to the sphere of things unexplored by modern science.
The information collected from medical practice has revealed trends that increase the risk of kidney formation of a wiener:
- alcohol dependence;
- tobacco smoking;
- chemical addiction;
- weighed down by heredity;
- by radiation irradiation;
- obesity.
But even in the event that none of these factors affect the human body, the fact of the disease can not be completely ruled out.
The development of the disease occurs at different rates, depending on the presence of concomitant diseases, the activity of the immune system.
The pathogenesis of the disease is also not fully understood, but all studies support the formation of a lipoma, like a malignant tumor, from a single cambial cell that begins active division.
Symptoms of
Until the time when the lipoma is small, it does not have any clinical signs that would allow it to be detected. Diagnosis often occurs by chance, during an ultrasound.
But with the growth of education-zhirovik, the symptomatology begins to manifest itself. First, in most cases there is hematuria - getting into the urine of blood cells. With microhematuria, the phenomenon can only be detected by laboratory urine analysis, but with macrohematuria, urine takes on a pink, red or even brown hue that can not be overlooked.
If the lipoma compresses the renal arteries, which happens almost always, the person begins to increase blood pressure. This process is associated with the development of the body by renin in order to eliminate the local decrease in the rate of blood flow in the kidney. But because of the physical obstruction, the narrowing of the vessels can not be eliminated, so the concentration of renin is constantly growing, causing persistent hypertension, which is difficult to eliminate without an elaborate set of preparations.
Men have their own distinctive symptom, which helps in the process of diagnosis - the expansion of the veins of the spermatic cord. Also, patients can present a large number of nonspecific complaints, if the lipoma compresses the organs located directly next to the affected kidney.
When the lipoma reaches a large size, it can be palpated with fingers.
Diagnosis
Nephrologic lipoma is one of the diseases diagnosed often by accident, when examined for another pathology in the kidney or abdominal cavity. Widow detection is carried out on ultrasound.
After this person is sent to the second, more thorough and accurate stage of functional diagnosis, for computer or magnetic resonance imaging. The study gives the doctor complete information about education: its precise localization, structure, size.
Sometimes the diagnosis includes an X-ray examination, which is less informative than CT and MRI, and nephrobiopsy, which, despite the high degree of informativeness for diagnosis, is painful and dangerous.
In the process of collecting data to confirm the diagnosis, the doctor can prescribe a complete urine test to identify the erythrocyturia.
Treatment
Conservative
Drug treatment is used if the diagnosis showed two factors:
- the size of the lipoma is up to 45 mm;
- no symptoms.
In this case it is illogical to expose the patient to the risk of surgical intervention, so physicians stop on a conservative approach.
This stage has two main directions: careful control of the tumor and its growth, changes in structure and shape, as well as inhibition of growth of the lipoma.
- To perform medical supervision, the patient should visit the ultrasound unit at least once every 90-100 days, do CT twice a year, and regularly take urine tests. At the first symptoms of pathology( pain, change in the color of urine, increase in blood pressure), you should immediately go to the doctor.
- The treatment uses interferon, which inhibits the activity of the immune system, thereby reducing the progression of tumor growth. This method is not effective for all patients.
- Symptomatic treatment is used to maintain the patient's well-being before performing a surgical operation: as there are no symptoms for the continuation of conservative therapy. To normalize and stabilize the blood pressure level, a complex of ACE inhibitors, calcium channel blockers and angiotensin receptors is used. To eliminate pain, analgesics are used. At this stage it is important to observe the hyponatrial diet and control over diuresis.
Folk methods
Treatment with folk methods for kidney fats is permissible only after consulting a doctor and getting approval and only at the asymptomatic stage. Before you begin to treat the lipoma with any prescription, it is important to consider the ability of some components of the composition to cause allergies, as well as the filtration ability of the kidneys.
The most popular are such folk remedies:
- Propolis tincture, which can be bought at a pharmacy. Thirty drops of the drug should be diluted in a small amount of water and drink three times a day. The effectiveness of the method can be estimated at the end of the course, which lasts 3 months.
- Alcoholic tincture from walnut can be prepared by your efforts: green fruits must be cut, placed in a glass container so that they occupy at least a third of its volume, pour vodka. After a month, tincture can be used to treat zhirovik two tablespoons twice a day.
- Bitter wormwood in the form of a tincture is taken three times a day for 15-20 drops.
Surgical intervention
If the patient develops a symptomatic picture on the background of the nephrologic lipoma, and the tumor size approaches 5 cm, the doctor decides on the surgical procedure.
There are two ways to remove the lipoma: resection and embolism.
Resection is a decades-old method of treating kidney lipoma, in which the tumor, together with the capsule, is removed from the organ. The operation is under general anesthesia, followed by a long rehabilitation period. Given the unexplained causes of the disease, it is difficult to predict the risk of relapse, but, as a rule, the outcome of treatment is safe.
The embolic method is the removal of a vessel that feeds the tumor. When the blood supply of the lipoma stops, the tumor stops growing, and then gradually decreases in size. This method of therapy has been practiced recently, but has already been appreciated by both doctors and patients.
If the tumor is extensive and there is no way to remove it, or if the kidney function is completely lost, doctors use a nephrectomy - kidney removal. According to statistical data, this happens infrequently.
On video resection of the kidney: