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Current Treatment and Outcomes of Perinephric Abscesses

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 4 Part 1 Linguagem: Inglês

10.1016/s0022-5347(05)64443-6

1527-3792

Maxwell V. Meng, Layla A. Mario, Jack W. McAninch,

Infectious Disease Case Reports and Treatments

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Oct 2002Current Treatment and Outcomes of Perinephric Abscesses Maxwell V. Meng, Layla A. Mario, and Jack W. McAninch Maxwell V. MengMaxwell V. Meng , Layla A. MarioLayla A. Mario , and Jack W. McAninchJack W. McAninch View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64443-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We characterize the treatment and outcomes of perinephric abscesses in a contemporary cohort of patients. Materials and Methods: We reviewed the experience with perinephric abscesses at a single community based hospital. Abdominal computerized tomography (CT) was widely available during the study period and experience with radiographic guided percutaneous drainage was extensive. Therapy and intervention for individual patients were dictated by the treating physician. Results: Of the 25 patients identified with perinephric abscesses 3 (12%) ultimately died. Although 40% had multiple risk factors for perinephric abscesses only 35% were identified at presentation. Urine cultures were positive in 72% of patients and CT had a diagnostic sensitivity of 92%. Ten patients with a mean abscess size of 1.8 cm. were treated with antibiotics alone (mean hospitalization 10 days) while 11 with a mean abscess size of 11 cm. received antibiotics and initial percutaneous drainage (mean hospitalization 30 days). Of the 11 patients treated with percutaneous drainage 4 ultimately required surgical exploration and nephrectomy. Conclusions: The clinical characteristics of perinephric abscesses have not changed significantly but improved imaging with CT allows earlier diagnosis and treatment, which likely contributed to the reduced mortality in our cohort compared to historical series. With accurate staging and careful followup, a variety of treatments can be successful, including antibiotics alone or in conjunction with percutaneous drainage and urinary drainage. Open surgical drainage and nephrectomy may eventually be required in some patients and should be considered if adequate drainage is not achieved. References 1 : Perinephric abscess: a report of 71 cases. J Urol1967; 98: 296. Link, Google Scholar 2 : Perinephric abscess: current concepts in diagnosis and management. Am Surg1969; 35: 72. Google Scholar 3 : Utility of CT-guided abdominal aspiration procedures. AJR Am J Roentgenol1982; 139: 1111. Google Scholar 4 : Computed tomography and ultrasonography for diagnosis and treatment of renal and retroperitoneal abscesses. Urol Clin North Am1982; 9: 185. Google Scholar 5 : Renal and perirenal infection: the role of computerized tomography. J Urol1985; 133: 375. Link, Google Scholar 6 : Medical treatment of renal and perirenal abscesses: CT evaluation. Clin Radiol1999; 54: 792. Google Scholar 7 : Perinephric abscess: a review of 26 cases. J Urol1977; 118: 910. Link, Google Scholar 8 : Renal abscesses: classification and review of 40 cases. Urology1980; 16: 333. Google Scholar 9 : Perinephric abscess: modern diagnosis and treatment in 47 cases. Medicine1988; 67: 118. Google Scholar 10 : Renal and perirenal abscesses. Infect Dis Clin North Am1997; 11: 663. Google Scholar 11 : Perinephric abscess: current concepts. J Urol1987; 137: 191. Link, Google Scholar 12 : Perinephric abscess: the missed diagnosis. Med Clin North Am1988; 72: 993. Google Scholar 13 : Perinephric abscess. Medicine1974; 53: 441. Google Scholar 14 : Minimally invasive treatment of renal abscess. J Urol1996; 155: 52. Link, Google Scholar From the Departments of Urology, University of California San Francisco and San Francisco General Hospital, San Francisco, California© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAbreu D, Osorio F, Guido L, Carvalhal G and Mouro L (2018) Retroperitoneal Infections by Community Acquired Methicillin Resistant Staphylococcus AureusJournal of Urology, VOL. 179, NO. 1, (172-176), Online publication date: 1-Jan-2008.SHU T, GREEN J and ORIHUELA E (2018) RENAL AND PERIRENAL ABSCESSES IN PATIENTS WITH OTHERWISE ANATOMICALLY NORMAL URINARY TRACTSJournal of Urology, VOL. 172, NO. 1, (148-150), Online publication date: 1-Jul-2004. Volume 168Issue 4 Part 1October 2002Page: 1337-1340 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.KeywordspyelonephritisantibioticsabscessdrainageMetricsAuthor Information Maxwell V. Meng More articles by this author Layla A. Mario More articles by this author Jack W. McAninch More articles by this author Expand All Advertisement PDF downloadLoading ...