Quiz page November 2011: Hypertension with urination.

摘要

A 48-year-old man with no known medical conditions presented with concerns of severe headache, dizziness, and palpitations every time he urinated for the last 5 years. His discomfort while urinating had led him to avoid drinking water unless absolutely thirsty. He did not report hematuria or drag use. Blood pressure was 130/90 mm Hg while sitting and increased to 200/110 mm Hg during micturition. No other abnormal findings were noted on physical examination. Complete blood cell count, serum electrolyte, coagulation profile, kidney function, and liver enzyme values were unremarkable. Ultrasound of the abdomen and pelvis showed a tabulated mass (35 X 27 mm) along the left anterolateral wall of the urinary bladder, showing vascularity. Computed tomography confirmed this mass, measuring 27 X 21 mm in the left inferolateral wall of the urinary bladder with prominent feeding vessels (Fig 1).