Presentation
Left flank pain. Fever. Ultrasound suggested left kidney mass. Abscess?
Patient Data
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Large left-sided renal abscess displacing the remaining or the kidney anteriorly. No renal stones.
Gallstones. No free fluid.
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Percutaenous drainage requested. Unable to undertake with US
Prone position.
The abscess was entered with an access needle.
Seldinger technique.
12F drain inserted.
Frank pus drained freely.
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The key steps in the Seldinger process illustrated.
Case Discussion
CT may be required for drainage procedures.
Reasons include:
- size of patient
- depth of the collection
- unable to get a safe window for drainage
- inadequate visualization (i.e collection of mixed echogenicity)
Unlike ultrasound where a direct puncture is an option for ultrasound-guided drainage, CT requires the Seldinger technique for drain insertion.