Infected perinephric haematoma
Known renal stone disease. Sudden onset left flank pain. Infection?
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2cm depth left perinephric haematoma (HU 60) with several small foci of gas within. Small amount of gas in the renal parenchyma. The left kidney is displaced anteromedially. Perinephric stranding.
Bilateral nephrolithiasis. No ureteric stone. No hydronephrosis.
Small amount of blood in the pelvis.
In this case, no given history of intervention pro-offered (Eg, PCNL, lithotripsy or attempted aspiration) to explain the haemorrhage and perinephric gas.
The gas in largely within the perinephric haematoma, not the renal parenchyma. The HU is indicative of blood and an attempted aspiration also yielded a small volume of clotted blood.
Spontaneous perinephric haematomas may occur. The gas relates to secondary infection.
Aspiration and subsequent culture grew Staphalococcus.