酷似肠梗阻的严重气肿性肾盂肾炎

Severe emphysematous pyelonephritis mimicking intestinal obstruction.

作者信息

Sun Ji Ning, Zhang Bao Long, Yu Hai Yan, Wang Bin

机构信息

Shandong Medical Imaging Research Institute, Shandong University, No. 324, JingWu Road, Jinan 250021, Shandong, China; Department of Radiology, Weifang People's Hospital, No. 151, Guangwen Street, Kuiwen District, Weifang 261041, Shandong, China.

Department of Radiology, Weifang Maternity and Child Care Hospital, No. 76, Qingnian Road, Weicheng District, Weifang 261011, Shandong, China.

出版信息

Am J Emerg Med. 2015 Dec;33(12):1846.e3-6. doi: 10.1016/j.ajem.2015.04.041. Epub 2015 Apr 24.

DOI:10.1016/j.ajem.2015.04.041

PMID:25957142

Abstract

Emphysematous pyelonephritis is a severe necrotizing infection characterized by the presence of gas and/or fluid in the renal parenchyma, collecting system, or perirenal tissues. Emphysematous pyelonephritis with approximately 15 cm air-fluid level, diffused ureteral involvement, and the accumulation of gas in liver and peritoneal cavity is very rare. Here, we reported a severe emphysematous pyelonephritis with multiple huge air-fluid level mimicking intestinal obstruction and with the accumulation of gas in liver and ureter in computed tomography imaging. The patient was successfully managed by percutaneous nephrostomy combined with medical treatment.

摘要

气肿性肾盂肾炎是一种严重的坏死性感染，其特征为肾实质、集合系统或肾周组织中存在气体和/或液体。气肿性肾盂肾炎伴有约15厘米的气液平面、输尿管弥漫性受累以及气体在肝脏和腹腔内积聚的情况非常罕见。在此，我们报告了一例严重的气肿性肾盂肾炎，在计算机断层扫描成像中可见多个巨大气液平面，类似肠梗阻，且气体在肝脏和输尿管内积聚。该患者通过经皮肾造瘘术结合药物治疗成功治愈。