Emphysematous pyelonephritis and pyonephrosis

Case contributed by Dr Ian Bickle

Presentation

Diabetic with sepsis. Source unknown. Ultrasound identified a left sided hydronephrosis.

Patient Data

Age: 55
Gender: Female
Modality: CT

Left hydronephrosis due to an obstructing ureteric stone.

Additional renal stones.

Perinephric fat stranding and thickening of Gerota's fasica.

Air in the renal cortex and collection system.

Modality: Fluoroscopy

Nephrostomy tube insertion for obstructed septic renal tract.

A pyonephrosis was confirmed.

Modality: Photo

Content of collecting system.

60mls of frank pus aspirated on table.

Case Discussion

Pyonephrosis can be life threatening.  The commonest cause is an obstructed tract secondary to urolithiasis.

Nephrostomy tube insertion is the procedure of choice - essentially synonymous with abscess drainage.

 

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Case Information

rID: 29648
Case created: 11th Jun 2014
Last edited: 14th Mar 2016
Inclusion in quiz mode: Included

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