Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan.
J Infect Chemother. 2011 Aug;17(4):541-3. doi: 10.1007/s10156-010-0206-x. Epub 2011 Jan 18.
A 67-year-old woman diagnosed with pyonephrosis and perinephric abscess because of an impacted urinary stone in the pelvicoureteric junction was admitted to the hospital with a high-grade fever. Although construction of a right nephrostomy for drainage of the abscess improved her general condition, she had a fever again 2 weeks after the initial treatment. Computed tomography revealed a persistent perinephric retroperitoneal abscess and a second drainage procedure was performed. Then, imaging examination revealed fistula formation between the cavity of the perinephric retroperitoneal abscess and the duodenum. The patient received conservative management including percutaneous drainage, discontinuation of oral intake, and antimicrobial chemotherapy. Three days after the second drainage and discontinuation of oral intake, imaging examination revealed complete closure of the fistula. Fistula formation between a perinephric abscess and the duodenum is very rare but a favorable outcome was obtained by our conservative management.
一位 67 岁女性因骨盆输尿管交界处嵌顿性尿路结石而被诊断为脓肾和肾周脓肿，因高热住院。虽然右肾造口术引流脓肿改善了她的一般状况，但初次治疗后 2 周她又出现发热。计算机断层扫描显示肾周腹膜后脓肿持续存在，进行了第二次引流术。随后，影像学检查显示肾周腹膜后脓肿腔与十二指肠之间形成瘘管。患者接受了包括经皮引流、停止口服摄入和抗菌化学疗法在内的保守治疗。第二次引流和停止口服摄入 3 天后，影像学检查显示瘘管完全闭合。肾周脓肿与十二指肠之间形成瘘管非常罕见，但我们的保守治疗获得了良好的结果。
