Abstract
Objective
The objective was to describe the last 10 years’ experience of the diagnosis and treatment of renal, perinephric, and mixed abscesses in an academic reference center.
Patients and Methods
The medical records of 65 patients with renal, perinephric, and mixed abscesses treated at our hospital from January 1992 to December 2002 were reviewed. The data collected included predisposing factors, symptoms, physical examination, initial diagnosis, laboratory and radiologic evaluation, treatment, and clinical outcome.
Results
Perinephric abscesses were found in 33 (50.8%) patients, renal abscesses were found in 16 (24.6%), and 16 (24.6%) had mixed abscesses. Urolithiasis (28%) and diabetes mellitus (28%) were the most common predisposing conditions. The duration of symptoms before hospital admission ranged from 2 to 180 days (mean 20 days). Urine culture was positive in 43% of patients and blood culture was positive in 40% of patients. Most of the perinephric abscesses received an interventional treatment: surgical drainage (24%), percutaneous drainage (42%) or nephrectomy (24%). Most patients were cured (73.3%) on discharge from hospital. Mixed (renal and perinephric) abscess treatment was similar: percutaneous drainage (37.5%), surgical drainage (18.75%) or nephrectomy (37.5%). Most patients were cured (60%) on discharge from hospital. Renal abscesses, however, were treated medically in 69% of patients and 73% were cured on discharge from hospital.
Conclusions
Perinephric and mixed abscesses are successfully managed by interventional treatment. Renal abscesses can be managed by medical treatment only, reserving interventional treatment for large collections or patients with clinical impairment. Early diagnosis is an important factor in the outcome of renal and perinephric abscesses.
Similar content being viewed by others
References
Thorley JD, Jones SR, Sanford JP. Perinephric abscess. Medicine 1974;53:441–451
Salvatierra O, Bucklew WB, Morrow JW. Perinephric abscess: a report of 71 cases. J Urol 1967;98:296–302
Adachi RT, Carter R. Perinephric abscess: current concepts in diagnosis and management. Am Surg 1969;35:72–75
Fowler JE, Perkins T. Presentation, diagnosis and treatment of renal abscesses: 1972–1988. J Urol 1994;151:847–851
Manjon CC, Sanchez AT, Lara JDP, Silva VM, Betriu GC, Sanchez AR, et al. Retroperitoneal abscesses—analysis of a series of 66 cases. Scand J Urol Nephrol 2003;37(2):139–144
Meng MV, Mario AL, Mcaninch JW. Current treatment and outcomes of perinephric abscesses. J Urol 2002;168:1337–1440
Sundaram M, Wolverson MK, Heiberg E, et al. Utility of CT-guided abdominal aspiration procedures. AJR Am J Roentgenol 1982;139:111–115
Hoverman IV, Gentry LO, Jones DW, et al. Intrarenal abscess. Report of 14 cases. Arch Intern Med 1980;140(7):914–916
Anderson KA, McAninch JW. Renal abscesses: classification and review of 40 cases. Urology 1980;16:333–338
Sheinfeld J, Erturk E, Spataro RF, et al. Perinephric abscess: current concepts. J Urol 1987;137:191–194
Fowler JE. Bacteriology of branched renal calculi and accompanying urinary tract infection. J Urol 1984;131:213–217
Herlitz H, Westberg G, Nilson AE. A perinephric abscess in a diabetic woman: successful conservative treatment. A case report. Scand J Urol Nephrol 1981;15(3):337–340
Dalla Palma L, Pozzi-Mucelli F, Ene V. Medical treatment of renal and perirenal abscesses: CT evaluation. Clin Radiol 1999;54(12):792–797
Siegel JF, Smith A, Moldwin R. Minimally invasive treatment of renal abscess. J Urol 1996;155:52–55
Haaga JR, Weinstein AJ. CT-guided percutaneous aspiration and drainage of abscesses. AJR Am J Roentgenol 1980;135(6):1187–1194
Elyaderani MK, Subramanian VP, Burgess JE. Diagnosis and percutaneous drainage of a perinephric abscess by ultrasound and fluoroscopy. J Urol 1981;125(3):405–407
Edelstein H, McCabe RE. Perinephric abscess. Modern diagnosis and treatment in 47 cases. Medicine (Baltimore). 1988;67(2):118–131
Levin R, Burbige KA, Abramson S, et al. The diagnosis and management of renal inflammatory processes in children. J Urol 1984;132(4):718–721
Fernandes RCSC, Duarte PDAC. Perinephric and renal abscesses in children: a study of three cases. Rev Inst Med Trop Sao Paulo 2002;44(6):341–344
Wang IK, Chen YM, Chen YC, et al. Successful treatment of renal abscess with percutaneous needle aspiration in a diabetic patient with end-stage renal disease undergoing hemodialysis. Ren Fail 2003;25(4):653–657
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Coelho, R.F., Schneider-Monteiro, E.D., Mesquita, J.L.B. et al. Renal and Perinephric Abscesses: Analysis of 65 Consecutive Cases. World J. Surg. 31, 431–436 (2007). https://doi.org/10.1007/s00268-006-0162-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-006-0162-x