Presentation
Left flank pain, fever.
Patient Data
Trace effusions. Bladder wall thickening with catheter.
Minimal right hydroureter with few subtle areas of cortical hypoenhancement (easiest to see on coronal images).
Mild left hydroureteronephrosis with diffuse hypoenhancement, several small cortical collections and larger coalesced lower pole exophytic collection.
Improving complicated left pyelonephritis with small cortical collections and larger lower pole collection following placement of a percutaneous pigtail catheter (via US).
Some volume loss/scarring of the left kidney. No residual collection following drain removal.
Case Discussion
This series shows presentation, treatment, and resolution of left renal abscesses.
The first series shows the difference between uncomplicated pyelonephritis (right kidney), and complicated pyelonephritis (left kidney), which has several cortical microabscesses and a large coalescing abscess in the lower pole extending exophytically into the paranephric space.
Following successful treatment with antibiotics (E. coli in abscess culture) and drainage, there is chronic scarring and volume loss of the left kidney.