[Pyeloduodenal fistula, secondary to lithiasic pyonephrosis].
Report on one patient presenting pyelo-duodenal fistula secondary to pyonephrosis by an obstructive calculus in lumbar ureter, treated conservatively with percutaneous nephrostomy.
Aged↗
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[Spontaneous renocolic fistula secondary to pyonephrosis of lithiasic etiology].
Description of one case of spontaneous fistulization between a renal calix and a descending colon, secondary to lithiasic pyonephrosis. Diagnosis was carried out by means of ascending pyelography without it being clinically suspected. Treatment is surgical, combining nephrectomy, fistula resection and closure of the colic gap. Etiology, favouring factors, diagnosis and treatment are explained.
Aged↗
[A case of pyonephrosis with septic shock in a hemodialysis patient treated successfully by retroperitoneal drainage].
A 56-year-old man on long-term hemodialysis was admitted to our hospital with complaints of right back pain and low-grade fever. Physical examination and laboratory data revealed severe hypotension and coagulopathy. Abdominal computed tomography showed a low dense area at the back of the right atrophic kidney. Under the clinical diagnosis of pyonephrosis spreading around the kidney with septic shock and disseminated intravascular coagulation, we performed drainage of retroperitoneal abscess. General condition improved postoperatively and right nephrectomy was performed two weeks after the drainage.
Abdominal Abscess↗
[Pyonephrosis on account of an ectopic ureterocele].
A case of isolated pyonephrosis on account of an ectopic ureterocele in a thirteen-month-old boy without bacteriuria is presented. The importance of early diagnosis and treatment is emphasized.
Choristoma↗
[Pneumoperitoneum: infrequent complication of lithiasic pyonephrosis].
A case of lithiasic pyonephrosis evolving with intrapyelic gas formation, with positive urinary culture for Escherichia coli, is presented. Original clinical presentation was a picture of acute peritonitis with pneumoperitoneum. Clinical and radiological findings were indicative of exploratory laparotomy. The picture was resolved surgically, the procedure adopted being nephrectomy with retroperitoneal space drainage and empirically chosen antibiotics. The paper establishes the uncommon nature of this complication, and includes a literature review.
Aged↗
[Pyonephrosis as a cause of acute peritonitis. Review of the literature and report of a case].
We report on a 52-year-old patient with spontaneous intraperitoneal rupture of pyonephrosis. The diagnostic features, preoperative findings and treatment are discussed and the literature reviewed.
Abdomen, Acute↗
[Percutaneous nephrostomy in the treatment of pyonephrosis. A comparative study apropos of 36 cases].
This study is a comparison of the treatments used in 36 patients suffering from pyonephrosis. The patients were subdivided in two groups: cases having undergone previous percutaneous drainage; and cases having undergone primary nephrectomy. These latter cases presented a high complication rate. We believe that preliminary drainage by percutaneous nephrostomy, constitutes the procedure of choice, when ever possible, to drain the kidney and prepare the patient for nephrectomy.
Adolescent↗
[Peritonitis by ruptured pyonephrosis (author's transl)].
The authors have observed one case of peritonitis by ruptured lithiasis pyonephrosis. The elective treatment of this unusual (13th case in the literature) complication of the urinary lithiasis is the nephrectomy.
Adult↗
[Reno-colonic and reno-cutaneous fistula in calculous pyonephrosis. Apropos of a case].
The authors present a case of reno-colonic and renocutaneous fistula in a patient with calculous pyonephrosis. The diagnosis was established by retrograde pyelography as the IVP showed no contrast excretion by the right kidney. Surgical treatment consisted of nephrectomy, colonic fistula excision and suture of the colonic wall without a diversion operation.
Adult↗
[A case of malignant fibrous histiocytoma occurring in the retroperitoneum with giant pyonephrosis].
A case of malignant fibrous histiocytoma (MFH) occurring in th retroperitoneum with giant pyonephrosis is reported. The patient was a 45-year-old male and his chief complaint was an abdominal mass. The abdominal fullness progressed so rapidly that he was admitted to our hospital. After examination, this case was diagnosed as a malignant tumor with left hydronephrosis, and an operation was performed on August 5, 1982. At operation, the left kidney contained about 11,000 ml of a pus-like fluid and in the retroperitoneum was found a hen-egg-sized solid tumor which was invading into the left kidney and the feeding vessels of the descending colon. So the tumor, left kidney and a part of the descending colon were resected en bloc. Pathological diagnosis was malignant fibrous histiocytoma. Chemotherapy (PPM regimen) and immunotherapy (OK-432) were administered after the operation, but multiple metastases appeared in the liver and bilateral lungs within 3 months. Then, the CY-VA-DIC regimen was followed. But, local recurrence was found in about 5 months, and the patient died on the 174 th day after the operation. Local recurrence and metastases in the liver, bilateral lungs, pleura and bones were confirmed at autopsy. Besides our case, a review of case reports of retroperitoneal MFH in Japan and comments are presented.
Histiocytoma, Benign Fibrous↗
Diagnosis and treatment of pyonephrosis.
This article examines current radiologic imaging and interventional techniques used in the diagnosis and initial treatment of pyonephrosis. Included is a review of all pyonephrotic series published in the English literature since 1970. Although the authors found that two thirds of pyonephrotic kidneys are still removed at surgery, there is an increasing emphasis on preservation of renal function. Percutaneous nephrostomy provides an excellent tool for drainage of pus and determination of residual renal function prior to definitive surgery.
Adolescent↗
[Pyonephrosis: a symptom manifesting a ureteral tumor. Apropos of 4 case reports].
The author reports four cases of unilateral pyonephrosis revealing ureteral tumors. None of the patients presented with a case history of hematuria. Retrograde ureteropyelography, using Chevassu's method, was suggestive of a ureteral tumor which was in fact discovered at operation. Frozen sections identified the type of tumor involved: a urothelial carcinoma.
Carcinoma, Transitional Cell↗
The management of pyonephrosis.
The treatment of 63 cases of pyonephrosis is described. The primary procedure in 39 patients (62%) was nephrectomy. A drainage procedure, usually nephrostomy, was performed in the remainder and in 10 cases an obstructing stone was removed. In 13 cases (21%) a useful functioning kidney resulted from conservative surgery. The indications for the different treatments are discussed.
Adolescent↗
[Spontaneous renocolic fistula from lithiasic pyonephrosis (author's transl)].
A patient developed a spontaneous communication between the left kidney pelvis and the descending colon following a lithiasic pyonephrosis. Signs of sepsis were present and diagnosis was based on urological findings only. Treatment consisted of left nephrectomy combined with a colectomy and an end-to-end anastomosis of the large intestine. The published literature is reviewed.
Colonic Diseases↗
[Renoduodenal fistula secondary to pyonephrosis].
Presentation of one case of renoduodenal fistula due to pyonephrosis in an oligophrenic female patient. In view of the patient's characteristics, the clinical picture was highly developed at presentation which resulted in failure of the conservative treatment. We emphasize the diagnostic and therapeutical methodology followed. Also, we include a literature review on this disease.
Adult↗
[Pyonephrosis caused by torulosis glabrata].
Fungal urinary infections are becoming increasingly frequent as a result of widespread use of broad spectrum antibiotics, an increased number of immunocompromised patients and the greater longevity of chronic patients. Urinary tract infections by Toruplosis glabrata only come second in frequency after those caused by Candida albicans, accounting for 5 to 25% of all infections caused by fungi. The paper presents one case of pyonephrosis by Toruplosis glabrata in a female patient treated with fluconazole who later underwent nephrectomy. A description is made of the clinical picture, diagnosis and treatment of these infections.
Cryptococcosis↗
[A rare complication of renal lithiasis: peritonitis and splenic abscess caused by rupture of pyonephrosis].
Peritonitis can result from many causes. We report a case caused by a renal abscess which contaminated the abdominal cavity. A 30-year-old patient was referred with suspected ruptured ectopic pregnancy with signs of peritoneal flooding. The culdocentesis was positive and returned frank pus. Endoscopic exploration with an open laparoscope revealed that the infection did not originate from a gynecological infection but did not identify the exact origin. Laparotomy was performed and revealed a splenic abscess and a subphrenic peritoneal breach releasing a purulent liquid. Splenectomy and abdominal lavage with draining was performed. A post-operative pyelourogram showed a silent kidney with multiple coralliform lithiases. Interventional sonography allowed drainage of a retroperitoneal collection. The post-operative period was uneventful. Left nephrectomy was later performed. Only rare cases of ruptured pyonephrosis leading to peritonitis have been reported, usually with poor prognosis.
Abscess↗
[Acute abdomen secondary to pyonephrosis. Perinephritic abscess with fistula to peritoneal cavity].
OBJECTIVE: To describe a case of acute abdomen arising from an underlying urological condition. METHODS/RESULTS: Herein we describe a patient with acute abdomen arising from a pyonephrotic kidney with fistulization to the peritoneal cavity. The clinical manifestations disappeared following nephrectomy by the anterior approach and drainage of the intraperitoneal cavity. CONCLUSION: Although infrequent, it should be taken into account that peritoneal abscess and/or pyonephrosis can cause acute abdomen when they fistulize to the peritoneal cavity.
Abdomen, Acute↗