Emphysematous Pyelonephritis Treated With Percutaneous Nephrolithotomy

Anthea Ki Kwan Lam, Giacomo Caddeo

Abstract


Emphysematous pyelonephritis (EPN) has a high rate of mortality due to sepsis as a complication of EPN, and majority of patients have a good outcome with a minimally invasive approach such as medical management by antibiotics and supportive care. Studies show that early nephrectomy should be reserved for those who do not respond to initial conservative management once the patient is stabilized. Decisions of management should take into account the patient’s current renal function which can be determined by looking at serum creatinine level or eGFR as to whether nephrectomy, percutaneous drainage or antibiotics would be most appropriate bearing in mind that a minimal approach of antibiotics alone has a higher risk of mortality compared with additional percutaneous drainage of abscess or nephrectomy. Although regarding this case, the patient had a background of congenital renal disease namely her medullary sponge kidney in addition to the formation of matrix stone which increased the severity of her already class IV EPN, conventional treatment via antibiotics was unsuccessful and so was nephrostomy drainage. Therefore unconventional method of percutaneous nephrolithotomy (PCNL) was adopted to treat her bilateral disease and this was successful as evident on the scans.




World J Nephrol Urol. 2014;3(4):151-153
doi: http://dx.doi.org/10.14740/wjnu145w

Keywords


Emphysematous pyelonephritis; Percutaneous nephrolithotomy; Nephrectomy

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

World Journal of Nephrology and Urology, quarterly, ISSN 1927-1239 (print), 1927-1247 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.wjnu.org   editorial contact: editor@wjnu.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada
© Elmer Press Inc. All Rights Reserved.