Learning objectives
Classification of emphysematous kidney lesions.
Epidemiology.
Guided percutaneous drainage techniques ; Tips and Tricks
Efficacy of guided percutaneous drainage.
Background
Emphysematous kidney lesions; include emphysematous pylitis,
emphysematous pylonephrosis (EPN) and perinephric abscess are relatively rare condition.
It results from sever parenchymatous kidney infection by anaerobic gas forming bacteria usually ascending infection.
E-coli is isolated on urine or pus cultures in nearly 70% of the reported cases.
EPN tends to be common in middle and old age patients ( usually > 50 year-old ) with uncontrolled diabetic (Up to 95% of the EPN cases ) and more common within females ( Few studies reported that female:...
Findings and procedure details
Guided percutaneous abscess drainage technique (PAD):
Under complete aseptic condition and local anesthesia.
We highlight the technique of the operation with different modalities according to the gas amount it usually a compination of two modalities either:
US
CT
Fluoroscopy
Tips and tricks:
Patient in prone position.
While introducing the guiding needle use the shortest pathway and the easiest angulation or localization.
In case of nephrostomy placement,
a lower pole posterior calix accessed via a subcostal approach is usually the bestfor urinary drainage.
posterior calix of...
Conclusion
Emphysematous kidney lesions are relatively rare yet serious condition more common within females with uncontrolled DM.
the standard management was nephrectomy yet A combination of percutaneous drainage with antibiotics offers an effective therapy for most cases with decrease risk of surgery and mortality.
Personal information
Omnia A.
Seyam,MSc.
assistant lecturer at intervention and diagnostic radiology department ,
Ain shams university ,
cairo,
Egypt.
[email protected]
References
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Boakes,
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& Batura,
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Deriving a management algorithm for emphysematous pyelonephritis: Can we rely on minimally invasive strategies or should we be opting for earlier nephrectomy? International Urology Nephrology (2017) 49: 2127.
https://doi.org/10.1007/s11255-017-1706-8.
Sugandh Shetty,Emphysematous Pyelonephritis (EPN)Treatment & Management.
emedicin.medscape.com,
Nov 13,
2017.
Ming-Tan Chen; Chun-Nung Huang; Yii-Her Chou; Chun-Hsiung Huang; Chin-Pei Chiang; Gin-Chung Liu.
Percutaneous Drainage in the Treatment of Emphysematous Pyelonephritis: 10-Year Experience.
The Journal of Urology,
1997;...