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Xanthogranulomatous pyelonephritis

Case contributed by Anton Aubanell Creus
Diagnosis almost certain

Presentation

Right side abdominal pain and urinary tract infection symptoms.

Patient Data

Age: 35 years
Gender: Female

Abdomen

x-ray

We can see the coraliform lithiasis in the right hemiabdomen of the patient suggesting chronic renal stone disease.

Urinary system

ultrasound

Enlarged right kidney with multiple stones in the renal pelvis and dilatation of calyceal structures. No abnormal flow on color Doppler imaging.

In this axial CT view, we can see the dilatation of the renal pelvis and loss of the normal renal architecture characteristic of xanthogranulomatous pyelonephritis.

We can see the MIP reconstruction of the coraliform lithiasis in this bone window.

Nephrostomy

Fluoroscopy

Nephrostomy was performed in order to preserve the functionality of the kidney.

Case Discussion

This patient had several prior episodes of complicated pyelonephritis and came to the emergency room with severe pain, fever and upper urinary tract infection symptoms.

Renal ultrasound and a CT of the abdomen and pelvis revealed xanthogranulomatous pyelonephritis.

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