Takemori Daigo, Satake Hirofumi, Kobayashi Shu
The Department of Urology, Hata Kenmin Hospital.
The Department of Urology, Chikamori Hospital.
Hinyokika Kiyo. 2022 Nov;68(11):349-353. doi: 10.14989/ActaUrolJap_68_11_349.
Emphysematous pyelonephritis (EPN) is a severe necrotic urinary tract infection accompanied by retention of gas in the kidney and areas around it. Formerly, emergency nephrectomy was the primary treatment, but the trend is shifting to treatment with maximum conservation of the kidney. In this report, two cases of EPN successfully treated by transurethral drainage are presented. The first case was in a 63-year-old woman with a history of poorly controlled diabetes. She arrived at the hospital by ambulance with primary symptoms of vomiting and trembling of the hands, and computed tomography (CT) revealed gas in the right renal calix. The second case was in a 61-year-old woman who arrived by ambulance with difficulty of body movement as the primary symptom, and CT revealed a calculus in the right ureter accompanied by right hydronephrosis and retention of gas in the right renal pelvis and right upper ureter. Both patients were diagnosed with EPN and treated by transurethral drainage rather than percutaneous drainage or nephrectomy because of their poor general condition. The treatment was successful. Along with percutaneous drainage, transurethral drainage is considered to be an option of surgical treatment for EPN.
气肿性肾盂肾炎（EPN）是一种严重的坏死性尿路感染，伴有肾脏及其周围区域的气体潴留。以前，急诊肾切除术是主要的治疗方法，但现在的趋势正转向最大程度保留肾脏的治疗方式。在本报告中，介绍了两例经尿道引流成功治疗的EPN病例。第一例是一名63岁女性，有糖尿病控制不佳的病史。她因呕吐和手部颤抖的主要症状被救护车送往医院，计算机断层扫描（CT）显示右肾盏有气体。第二例是一名61岁女性，因身体活动困难的主要症状被救护车送来，CT显示右输尿管有结石，伴有右肾积水以及右肾盂和右输尿管上段气体潴留。由于两位患者的全身状况较差，均被诊断为EPN并接受了经尿道引流而非经皮引流或肾切除术治疗。治疗取得了成功。除经皮引流外，经尿道引流被认为是EPN外科治疗的一种选择。
