[Emphysematous pyelonephritis: report of a case and review of the literature]. / Pielonefritis enfisematosa: presentación de un caso y revisión de la literatura.

Emphysematous pyelonephritis is a necrotizing renal parenquima infection, which is diabetes mellitus related in almost all cases. This is life threatening and has a high mortality rates despite aggressive management. The most important thing in management is a high diagnostic suspicious and also a rapid treatment, which means nephrectomy. We expose a case giving especial importance to clinical and image diagnose as treatment and evolution. We also make a literature review trying to understand this entity and find pathways for its therapeutic management.

Pielonefritis enfisematosa: presentación de un caso y revisión de la literatura / Emphysematous pyelonephritis: case report and literature review

La pielonefritis enfisematosa es una infección necrotizante del parénquima renal que afecta especialmente a pacientes diabéticos con mal control de su enfermedad. Esta grave afección conlleva altas tasas de mortalidad aún a pesar del tratamiento agresivo. Lo más importante en el manejo de la misma es un precoz diagnóstico y agresivo tratamiento, casi siempre con nefrectomía. Presentamos un caso clínico típico, haciendo especial hincapié en el diagnóstico clínico y por imagen, así como en el tratamiento, y en su evolución. Asimismo realizamos una revisión de la literatura intentando comprender mejor este proceso, y encontrar bases definidas para su abordaje terapéutico (AU)

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[Persistent Mullerian duct syndrome]. / Síndrome del conducto persistente de Müller.

We report on a 14-year-old boy who was admitted to the emergency department for acute retention of urine. At age 1 year, he had been submitted to surgery for left cryptorchidism and left-sided herniation, associated with hypospadias of the glans penis. Radiologic and endoscopic work up revealed a large retrovesical cavity with septation in its upper portion communicating with the prostatic urethra. These structures were removed and pathologic examination disclosed remnants of Müllerian ducts. This uncommon disease entity whose etiopathogenesis is ascribed to a deficient activity of the Müllerian inhibiting factor (MIF) classically presents in phenotypically male subjects with unilateral cryptorchidism, contralateral herniation, and persistent Müllerian remnants. The literature is reviewed, highlighting the diagnostic and therapeutic aspects of this syndrome.