并发双侧气肿性肾盂肾炎及继发的髂腰肌脓肿并累及大腿肌肉，伴有大量直肠出血。一种罕见的病例情况。
Concurrent bilateral emphysematous pyelonephritis and secondary iliopsoas abscess extending to thigh muscles with profuse rectal bleeding. A rare case scenario.
作者信息
Taha Diaa-Eldin, Raheem Ali Abdel, Aljarbou Abdulhkam, Haresy Mefarrih Yahya, Alrubat Abdelkarim, Alowidah Ibrahim
机构信息
Urology Department, King Saud Medical City, Riyadh, Saudi Arabia; Urology department, Kafrelsheikh University, Egypt.
Urology Department, King Saud Medical City, Riyadh, Saudi Arabia; Urology Department, College of Medicine, Tanta University, Tanta, Egypt.
出版信息
Int J Surg Case Rep. 2021 Sep;86:106289. doi: 10.1016/j.ijscr.2021.106289. Epub 2021 Aug 8.
INTRODUCTION
Bilateral emphysematous pyelonephritis is exceedingly rare.
CASE PRESENTATION
A 56 year old diabetic male presented with high grade fever 40 c, chills, and bilateral loin pain since two weeks a picture of septic shock. CT showed bilateral emphysematous pyelonephritis, the left kidney was smaller in size, the right renal unit showed marked hydronephrosis, right iliopsoas abscess extending to the thigh. The patient was managed by bilateral nephrostomy tubes and two retroperitoneal drains. Initially, the patient recovered, but the general condition deteriorated and profuse rectal bleeding occurred. Colonoscopy showed bleeding colonic mucosa.
CONCLUSION
Bilateral emphysematous pyelonephritis is devastating disease that should be managed promptly to avoid septic shock.
引言
双侧气肿性肾盂肾炎极为罕见。
病例介绍
一名56岁的糖尿病男性患者，两周来出现40摄氏度的高热、寒战和双侧腰痛，呈现感染性休克状态。CT显示双侧气肿性肾盂肾炎，左肾体积较小，右肾单位显示明显肾积水，右髂腰肌脓肿延伸至大腿。患者接受了双侧肾造瘘管和两个腹膜后引流管治疗。起初，患者有所恢复，但随后全身状况恶化并出现大量直肠出血。结肠镜检查显示结肠黏膜出血。
结论
双侧气肿性肾盂肾炎是一种严重疾病，应及时治疗以避免感染性休克。
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