Conservative Management of the Renal and Perirenal Abscesses / 대한비뇨기과학회지

PURPOSE: We critically evaluated the most appropriate management of renal and perirenal abscess and identified the set of patients who had benefited from conservative management. MATERIALS AND METHODS: Between May 1995 and June 1999, fifteen patients with renal (10 cases) and perirenal abscess (5 cases) were treated in our hospital. Among the fifteen patients, six patients were managed by antibiotics alone, the other nine patients were managed by percutaneous aspiration and antibiotics. Percutaneous abscess aspiration and drainage was done under ultrasound guidance and local anesthesia. RESULTS: On the urine culture, 4 cases had positive urine culture (27%); E. coli was in 3 cases, Klebsiella in 1 case respectively. On the blood culture, E. coli was in 2 cases. On the abscess culture (9 cases were performed), the organisms were identified in 8 cases (89%); E. coli was in 6 cases, S. aureus was in 1 case, S. epidermidis in 1 case respectively. CONCLUSIONS: We suggest that proper antibiotic therapy alone or combined with ultrasound guided percutaneous drainage of renal and perirenal abscesses is a choice of reasonable, safe and effective management in selected patients.

Percutaneous Management of the Renal and Perirenal Abscess / 대한비뇨기과학회지

Between July 1988 and June 1993, nine patients with renal and perirenal abscess were treated using the percutaneous management. Percutaneous abscess drainage was done under ultra- sound guidance and local anesthesia. Among the nine patients, two patients were managed by percutaneous aspiration only and the other seven patients were managed by continuous drainage using the 8.3F pig-tail or 14F Malecot catheter. The catheters were placed in the abscess cavity during the period from 4 days to 19 days (average 8 days). On the abscess culture, the organisms were identified in 9 cases ( 100%) ; E.coli was in 4 cases, S. aureus was in 2 cases, Proteus, Enterobacter, unidentified gram negative bacilli in 1 case, respectively. After catheter removal, all patients have remained free of symptoms during followup from 2 months to 32 months (average 20 months). We suggest that proper antibiotic therapy combined with ultrasound guided percutaneous drainage of renal and perirenal abscess is a choice of reasonable, safe and effective management in selected patients.

A Clinical Review of 16 Cases of Renal of Perirenal Abscess / 대한비뇨기과학회지

We reviewed retrospectively 16 cases of renal or perirenal abscess who were admitted to the St. Mary hospital during the period from January 1977 to December 1986. The results were as follows : 1. The average age of the patients was 27 years. 2. The average duration of symptom was 15 days. 3. On laboratory findings, 6 cases (31%) of pyuria and 2 cases (13%) of positive urine culture were seen. 4. Abscess culture was performed in 10 patients and 5 cases of staphylococcus and 2 cases of E. coli were cultured. The remained 3 cases were sterile culture. 5. Predisposing factors were involved in 6 cases (38%). Urologic predisposing factors were 5 cases (31%) and non-urologic predisposing factors were 4 cases (25%). 6. Surgical treatment was performed in 10 cases (63%) by 9 cases of incision & drainage and 1 case of nephrectomy. Non-surgical treatment was successful in 6 cases (37%) by 5 cases of antibiotics only and by 1 case of antibiotics with ultrasound guided percutaneous drainage.