Complicated pyelonephritis, splenosis

Case contributed by Michael P Hartung


Abdominal pain, fever; remote history of being kicked by a horse.

Patient Data

Gender: Female

Several small enhancing masses (splenules) in the left upper quadrant and left/mid abdominal omentum. Volume loss with cortical scaring in the left kidney. Focal pyelonephritis with microabscesses in the right upper and mid pole. Presumed reactive mild retroperitoneal adenopathy. Menstrual cup. 

Case Discussion

Complicated right pyelonephritis with developing microabscesses, not suitable for drainage. The patient has a history of blunt abdominal trauma (horse kick) accounting for the multiple splenules (splenosis), which manifests as several small enhancing masses in the left upper quadrant and mid/left abdominal omentum. With such a history and characteristic appearance, no further evaluation is necessary. 

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