Perinephric abscess drainage

Case contributed by Dr Bruno Di Muzio

Presentation

Diabetes mellitus, fever, malaise, and pain in the left flank.

Patient Data

Age: 80
Gender: Female
CT

CT performed in the emergency department

Left hydronephrosis secondary to obstruction by proximal ureteral calculi. Formation of large medial perirenal abscess in close contact with the left psoas muscle.

Pelvic right kidney.

Imaging-guided percutaneous drainage of the abscess was requested, ultrasound approach was chosen. 

Ultrasound

Percutaneous drainage performed by ultrasonography

Patient placed in right lateral decubitus. Ultrasound showed a left hydronephrosis. And the abscess with about 170 ml. The last image shows the multipurpose catheter ("pig-tail" 10 Fr) tip inside the abscess. 

CT

CT without contrast performed the following day

Scan after the procedure shows the catheter in situ and a significant reduction in the collection volume. 

Case Discussion

US-guided percutaneous drainage is one form of image-guided drainage, allowing minimally invasive treatment of collections, potentially anywhere in the body. 

A nephrostomy was further performed in the left kidney. 

 

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Case information

rID: 22397
Published: 29th Mar 2013
Last edited: 16th Jul 2018
Inclusion in quiz mode: Excluded

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