Abstract
Computed tomography and ultrasonography are effective methods for diagnosis and localization of renal and perinephric abscesses. In patients with clinical suspicion of sepsis, diagnostic needle aspiration of these lesions can be safely performed extraperitoneally by using sectional imaging for guidance. When an abscess is confirmed, small catheters can be introduced percutaneously via the diagnostic aspiration route to provide immediate decompression as well as continuous and definitive drainage without need for surgery. In 8 cases so treated, there were no major complications, deaths, or recurrences. These results, obtainable without the risks of surgery, indicate that patients with renal or perinephric abscesses should be offered a trial of percutaneous drainage as a definitive method of therapy. Those cases not amenable to percutaneous drainage, or those in which the procedure has failed, can then be drained surgically. Percutaneous abscess drainage is widely applicable because it can be performed in any uroradiologic facility with access to sectional imaging.
Similar content being viewed by others
References
Wright FW: Percutaneous diagnosis and treatment of intrarenal abscess.Br J Urol 49:22, 1977
Pedersen JF, Hancke S, Kristensen JK: Renal carbuncle: anti-biotic therapy governed by ultrasonically guided aspiration.J Urol 109:777–778, 1973
Klein DL, Filpe RG: Acute renal carbuncle.J Urol 118:912–915, 1977
Ng E, Rossiter SB, Reimer GW: Renal puncture: a neglected aid in the diagnosis of renal masses.West J Med 104:102–105, 1966
Smith EH, Bartrum RJ Jr: Ultrasonically guided percutaneous aspiration of abscesses.AJR 122:308–312, 1974
Mindell HJ: Percutaneous renal cyst puncture: unusual results in 2 cases.J Urol 114:332–336, 1975
Gerzof SG, Robbins AH, Birkett DH: Percutaneous catheter drainage of abdominal abscesses guided by ultrasound and computed tomography.AJR 133:1–8, 1979
Sanford JP: Perinephric abscess. In TH Harrison (ed):Campbell’s Urology, Vol. 1, Philadelphia: W.B. Saunders, 1978, pp 708–712
Salvatierra O Jr, Bucklew WB, Morrow JW: Perinephric abscesses: a report of 71 cases.J Urol 98:296, 1967
Malgieri JJ, Kursh ED, Persky L: The changing clinicopathological pattern of abscesses in or adjacent to the kidney.J Urol 118:230–232, 1977
Meyers MA:Dynamic Radiology of the Abdomen. New York: Springer-Verlag, 1976, pp 139–157
Gerzof SG, Robbins AH, Birkett DH: Computed tomography in the diagnosis and management of abdominal abscesses.Gastrointest Radiol 3:387–394, 1978
Haaga JR, Alfidi RJ, Havrilla TR, Cooperman AM, Seidelmann FE, Reich NE, Weinstein AJ, Meany TF: CT detection and aspiration of abdominal abscesses.AJR 128:465–474, 1977
Mendez G Jr, Isikoff MB, Morillo G: The role of computed tomography in the diagnosis of renal and perirenal abscesses.J Urol 122:582–586, 1978
Gerzof SG: The role of ultrasound in the search for introabdominal and retroperitoneal abscesses.Clin Diagn Ultrasound 7. In press
Goldman SM, Minkin SD, Naraval DC, Diamond AB, Poin SJ, Meringoff BN, Sidh SM, Sanders RC, Cohen SP: Renal carbuncle: the use of ultrasound in its diagnosis and treatment.J Urol 118:525–528, 1977
Schneider M, Becker JA, Staiano S, Campos E: Sonographic-radiographic correlation of renal and perirenal infections.AJR 127:1007–1014, 1976
Kressel HY, Filly RA: Ultrasonographic appearance of gascontaining abscesses in the abdomen.AJR 130:71–73, 1978
Koehler PR, Moss AA: Diagnosis of intra-abdominal and pelvic abscesses by computerized tomography.JAMA 244:49–52, 1980
Robbins AH, Pugatch RD, Gerzof SG, Faling J, Johnson WC, Spira R, Gale DR: Further observations on the medical efficacy of computed tomography of the chest and abdomen.Radiology. In press
Ball WS, Wicks JD, Mettler FA Jr: Prone-supine change in organ position: CT demonstration.AJR 135:815–820, 1980
Gronvall J, Gronvall S, Hegedus V: Ultrasound guided drainage of fluid-containing masses using angiographic catheterization techniques.AJR 129:997–1002, 1977
Ingram JM: Suprapubic cystotomy by trocar catheter: a preliminary report.Am J Obstet Gynecol 113:1108–1113, 1972
Ingram JM: Further experience with suprapubic drainage by trocar catheter.Am J Obstet Gynecol 121:885–891, 1975
DeCosse JJ, Fox PS: Subphrenic abscess.Surg Gynecol Obstet 138:841–846, 1974
Gerzof SG: Guided catheter drainage of abdominal abscesses. In Athanasoulis CA, Pfister RC, Greene R, Roberson G (eds): Interventional Radiology, Philadelphia: W.B. Saunders Co. In press
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gerzof, S.G. Percutaneous drainage of renal and perinephric abscess. Urol Radiol 2, 171–179 (1981). https://doi.org/10.1007/BF02926720
Issue Date:
DOI: https://doi.org/10.1007/BF02926720