BACKGROUND Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disorder, typically presenting with hypertension, hematuria, or progressive renal dysfunction. However, it can have a broad range of initial presentations and, in uncommon cases, may mimic other abdominal disorders. This report presents a case of ADPKD manifesting as an epigastric mass in a patient without a family history, highlighting its importance in the differential diagnosis of upper abdominal masses. CASE REPORT A 62-year-old woman presented to our primary care clinic with a 5-day history of a painless epigastric mass and right hypochondriac pain. She had hypertension and dyslipidemia, without a known family history of ADPKD. On examination, a firm mass was palpable in the epigastrium, accompanied by hepatomegaly. Laboratory investigations revealed mild renal insufficiency, microscopic hematuria, and proteinuria. The patient underwent abdominal ultrasonography and contrast-enhanced computed tomography, which demonstrated multiple cysts in both kidneys and the liver, consistent with ADPKD. She was evaluated by the hepatobiliary surgery team, who recommended symptomatic management. She was also assessed by the nephrology team; further evaluation for associated complications, including mitral valve prolapse and intracranial aneurysms, yielded normal findings. She continues regular follow-up with the primary care and nephrology teams for blood pressure optimization and renal function monitoring. CONCLUSIONS This case highlights the need to consider ADPKD in patients who present with upper abdominal masses. Early imaging and a multidisciplinary evaluation are essential for establishing an accurate diagnosis and ensuring appropriate management, particularly in patients without a clear family history.

Hematuria and flank pain are a typical urology emergency, often presented as the primary complaint. However, in patients with previous aortolia surgery, these symptoms may rarely indicate external compression of the urinary tract by an anastomotic pseudoaneurysm. We herein describe an unusual case of a 50-year-old man who presented to the urologist with hematuria and right flank pain due to ureteric compression by an aortic anastomotic pseudoaneurysm. He had undergone an open aortolia revascularization procedure with a bifurcated graft 9 years earlier and the pseudoaneurysm was found at the proximal anastomosis pressurizing the right ureter. The patient was successfully treated with a pigtail placement and an endograft implantation resulting in resolution of his symptoms. Urological symptoms in patients with a history of previous aortolia surgery should raise the suspicion of an anastomotic pseudoaneurysm.

Percutaneous renal biopsy (PRB) is the gold standard for diagnosing renal diseases. This study aimed to compare the specimen adequacy and safety of three ultrasound-guided PRB techniques: cross-sectional coaxial (Group A), longitudinal coaxial (Group B), and conventional longitudinal noncoaxial technique (Group C). This single-center retrospective study enrolled 184 adult patients who underwent PRB at Anhui Provincial Public Health Clinical Center between January 2019 and December 2025. All procedures were performed by experienced interventional radiologists. Outcomes included total glomerular yield, specimen adequacy, procedural time, and bleeding complications (perinephric hematoma, gross/microscopic hematuria). Baseline characteristics were comparable across groups. Specimen adequacy was 100% in Group A, 97.8% in Group B, and 89.1% in Group C. Group A exhibited significantly superior adequacy compared to Group C (p = 0.016). Group A had the shortest procedural time (1.45 ± 0.20 mins), which was significantly shorter than Group B (2.22 ± 0.35 mins) and Group C (2.61 ± 0.46 mins; all p < 0.001). The incidence of bleeding complications was significantly lower in Group A than in Group C (perinephric hematoma: p < 0.001; gross hematuria: p = 0.002; microscopic hematuria: p = 0.004). A significantly higher incidence of gross hematuria was also noted in Group A compared to Group B (p = 0.004). The cross-sectional coaxial technique for ultrasound-guided PRB provides better specimen adequacy, shorter procedural time, and a lower bleeding risk compared with longitudinal coaxial and conventional non-coaxial techniques. This combined approach may serve as an optimized strategy to improve PRB outcomes, although multicenter randomized trials are needed to confirm its generalizability.

To summarize existing literature on the outcomes of Hyperbaric Oxygen (HBO2) therapy for RC and focus on recent updates since the original 2018 scoping review.

Renal disease in people living with HIV extends beyond classical HIV-associated nephropathy to include immune-mediated and vasculitic lesions, of which pauci-immune crescentic glomerulonephritis is among the rarest and most easily missed. We describe two biopsy-proven cases with anti-myeloperoxidase anti-neutrophil cytoplasmic antibody positivity. The first, established on antiretroviral therapy, presented with a pulmonary-renal syndrome after empirical anti-tubercular treatment had failed; biopsy showed cellular crescents without chronic change, and corticosteroids with rituximab achieved sustained clinical, biochemical and serological remission. The second, antiretroviral-naive, had glomerular haematuria and proteinuria documented at HIV diagnosis and an ischaemic stroke soon afterwards, but declined nephrological assessment; biopsy 3 years later was dominated by global glomerulosclerosis and interstitial fibrosis and he remained dialysis-dependent. The divergence turned on the histological stage at diagnosis rather than antiretroviral status and argues for early biopsy whenever unexplained renal decline with an active urinary sediment occurs in HIV.