Emphysematous pyelonephritis and perinephric abscess Flashcards
1
Q
What is emphysematous pyelonephritis?
A
Acute necrotising parenchymal and perirenal infection caused by gas-forming uropathogens, usually E. coli
2
Q
Describe the aetiology of emphysematous pyelonephritis
A
- Usually occurs in diabetics
- Often associated with ureteric obstruction
3
Q
How does emphysematous pyelonephritis present?
A
- Fever
- Vomiting
- Flank pain
4
Q
What investigations are required in emphysematous pyelonephritis
A
- KUB x-ray - gas
- CT defines extent of emphysematous process
5
Q
How is emphysematous pyelonephritis managed?
A
- ITU support
- If not settling - nephrectomy
6
Q
What usually causes perinephric abscess formation
A
Usually results from rupture of an acute cortical abscess in the perinephric space or from haematogenous seeding from other sites of infection
7
Q
How does perinephric abscess usually present?
A
- Pyrexial
- ~33% not pyrexial - usually chronic abscess
- Flank mass in 50%
8
Q
What investigations are required in perinephric abscess?
A
- Bloods - high WCC, high serum creatinine
- Urine - pyuria
- CT
9
Q
How is perinephric abscess managed?
A
Antibiotics and percutaneous or surgical drainage
