Presentation
Diabetic with sepsis. Source unknown. Ultrasound identified a left sided hydronephrosis.
Patient Data
Age: 55 years
Gender: Female
From the case:
Emphysematous pyelonephritis and pyonephrosis
Axial non-contrast
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.
From the case:
Emphysematous pyelonephritis and pyonephrosis
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Frontal
Nephrostomy tube insertion for obstructed septic renal tract.
A pyonephrosis was confirmed.
From the case:
Emphysematous pyelonephritis and pyonephrosis
Clinical sample
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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