气肿性肾盂肾炎
Emphysematous pyelonephritis.
作者信息
Nayeemuddin Mohammed, Wiseman Oliver J, Turner Alan G
机构信息
Department of Urology, Edith Cavell Hospital, Peterborough, UK.
出版信息
Nat Clin Pract Urol. 2005 Feb;2(2):108-12. doi: 10.1038/ncpuro0095.
BACKGROUND
A 54-year-old nondiabetic male presented with high fever, vague lower abdominal pain and leakage of urine around his long-standing suprapubic catheter. Examination revealed pyrexia and tenderness in the right renal angle. White cell count was 22.8 x 10(9)/l. Plain abdominal X-ray showed calculi in the right kidney, ureter and bladder. Intravenous pyelogram showed gas confined to the right upper renal pelvis and perinephric space.
INVESTIGATIONS
Urine and blood cultures, plain abdominal X-ray, intravenous pyelogram, abdominal ultrasound, MAG3 renogram and histopathology.
DIAGNOSIS
Emphysematous pyelonephritis: class 2 or type 1. Escherichia coli was isolated from urine obtained by endoscopic drainage.
MANAGEMENT
Endoscopic drainage of pus and simple nephrectomy.
背景
一名54岁非糖尿病男性，出现高热、下腹部隐痛以及长期耻骨上导尿管周围尿液渗漏。检查发现右侧肾角发热且有压痛。白细胞计数为22.8×10⁹/L。腹部平片显示右肾、输尿管及膀胱有结石。静脉肾盂造影显示气体局限于右肾上极肾盂及肾周间隙。
检查
尿及血培养、腹部平片、静脉肾盂造影、腹部超声、巯基乙酰三甘氨酸肾图及组织病理学检查。
诊断
气肿性肾盂肾炎：2级或1型。经内镜引流获取的尿液中分离出大肠埃希菌。
治疗
内镜下脓液引流及单纯肾切除术。
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