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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45932
Experience:  Board Certified Physician
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MALE AGED 78. PERSISTENT GROSS HAEMATURIA WEEKS. HOWEVER,

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MALE AGED 78. PERSISTENT GROSS HAEMATURIA FOR 5 WEEKS. HOWEVER, LAST SEVEN DAYS HAS BEEN STEADILY DECREASING TO NORMAL COLOUR TO EYESIGHT. ALSO HAVE CT SCAN DYE SHOWING A FILLING DEFECT. PROBABLY TRANSITIONAL CELL IN PELVIC KIDNEY. POSSIBLY ALSO BLOOD CLOT ETC OR OTHER BV ABNORMALITY.
LAST YEAR HAD SEVERE FALL ON LEFT KIDNEY SIDE. CRACKED THREE RIBS. NO SIGN OF HAEMATURIA THEN. GRANDSON TENDS TO GIVE ME STRONG PLAYFUL PUNCHES IN THAT AREA,, HAEMATURIA BEGAN 2 DAYS AFTER ARRIVING IN USA FOR HOLIDAY. INVOLVED 8 HOUR SITTING IN PLANE, FOLLOWED BY 7 HOUR CAR DRIVE AND SOON FOLLOWED BY ANOTHER 4 HOUR CAR DRIVE.
QUESTIONS: A. WHAT IS THE POSSIBLE SIGNIFICANCE OF THIS PATTERN OF BLEEDING? IS IT A COMMON OR RECOGNIZABLE VARIATION IN PELVIC CANCERS.
B. COULD ALL THE SITTING AND EARLIER FALL BE CAUSATIVE OR PRECIPITANT FACTORS OF BLOOD CLOT ETC OR CANCER?
C INSTEAD OF IMMEDIATE MORE INVASIVE BIOPSY SHOULD I WAIT FOR A WEEK OR TWO MORE AND GET ANOTHER CT DYE SCAN TO COMPARE AND DETECT ANY REDUCTION IN THE LACUNA THANK YOU FOR A PROMPT REPLY IF POSSIBLE SINCE A BIOPSY IS TO TAKE PLACE FIRST THING TUESDAY AM. DR STANLEY JACOBS
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
A. The greatest concern when there has been gross hematuria for 5 weeks, the primary concern is that there is a cancer in the urinary tract. It is possible that bleeding could be due to benign growths or from inflammation, but bleeding that is longer in duration is more concerning for cancer. The pattern is not otherwise indicative of any specific cause.
B. It would be very unusual for the fall from last year to be contributing to any current bleeding. However, bleeding in the urine could be related to any activity that jostles the kidneys, including punches to the kidney area. We actually see this more often with certain exercises that jostle the kidneys, but if the trip involved significant jostling of the body, then it could contribute to the bleeding. However, bleeding that occurs from jostling the kidneys will usually resolve relatively quickly and it would be unusual for it to persist even one week, much less 5 weeks.
C. Usually, when bleeding has persisted for 5 weeks, it would be better to perform a biopsy of any abnormality that is seen on a CT scan.
If I can provide any additional information, please let me know.
Expert:  Dr. David replied 1 year ago.
This is Dr. DavidI am a cancer doctorit sounds like you have already had a CT scan which showed an abnormality in the left kidney showing a filling defect in the pelvis of the left kidney. this can be a transitional cell carcinoma or a renal cell primary kidney carcinoma.this mass is what is causing the bleeding.I am glad you are being setup for a biopsy first thing Tuesday.for the biopsy, they will do a CT or ultrasound guided biopsyand this imaging will tell your doctors if the filling defect is smaller or not. I suspect that it won't be smaller.a blood clot in the kidney would not cause hematuria like this. you will need 24 hour urine collection to check on your true GFR and creatine clearance kidney functionyou may have to see a uroloigst to talk about surgery to cut out part or all of your left kidneyyou will need to talk to your doctors about getting a CT scan of your chest abdomen and pelvis to look for signs of spread of a potential cancer in your left kidney.the bleeding pattern is not useful in helping to tell what type of cancer is going onyour prir traumas are not what is causing the bleeding.it is that filling defect in your left kidney which is bleeding and very likely to be a cancerlet me know if you have other questions.if done for now, please leave positive rating above the chat box so I can get credit for helping you todaywe only get credit for helping clients after positive feedbackyou can always reach me with "a question for Dr. David" in the medicine or oncology categories if you have any other questionshere is my website if you need to reach me again:http://www.justanswer.com/medical/expert-dr-david/Thanks for using JustAnswers.com