Presentation
Diabetic with left flank pain and fever for 1 day. O/E Lethargic. Hypotensive. Pyelonephritis?
Patient Data
Large subcapsular collection on the lateral aspect of the lefy kidney. The left kidney is compressed and displaced medially.
Perinephric stranding on the left with a few blebs air in the left kidney.
A small cystic structure in the right renal bed in keeping with a non-functioning kidney.
Cholecystectomy.
The steps of the modified Seldinger technique.
From skin markers to choose the site of puncture through to final drain position confirmation.
Case Discussion
The appearances are those of a subcapsular collection. These are typically subcapsular haematomas, which may or may not be secondarily infected. The air in this case suggests secondary infection.
Following drain insertion several hundred millilitres of liquified aged blood drained from this collection.
The large subcapscular collection has resulted in a Page kidney.
Compare and contrast this subcapsular collection with this companion case of a renal abscess.
https://radiopaedia.org/cases/renal-abscess-with-ct-guided-drainage
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