ABSTRACT
AIM: The purpose of the present study is to evaluate the role of image-guided drainage in emphysematous pyelonephritis (EPN). MATERIALS AND METHODS: We reviewed 11 patients with EPN treated either by ultrasonography (three patients) or computed tomography (CT)-guided drainage (eight patients). There were eight male and three female patients in our study with ages ranging from 24 to 75 years, mean 56.3 years. All the patients underwent plain radiography, ultrasonography and plain CT of the abdomen. Contrast-enhanced CT was performed in seven patients. RESULTS: Seven of 11 patients, were successfully treated with per cutaneous drainage. One patient died within 24 h (case 2), due to septicaemia. Three patients subsequently required nephrectomy. Replacement of the drainage catheter was required in one patient. The catheter was kept in situ, for an average of 17 days. The catheter drained pus and gas in all patients. The quantity of pus ranged from 300 to 2000 cm(3). All 10 patients improved symptomatically within 24 h of drainage, with improved urine output and serum creatinine levels within 48 h. CONCLUSION: CT-guided drainage of EPN has established itself as a safe, quick and life-saving palliative treatment of choice as opposed to conventional emergency nephrectomy. Excluding the patient who died, the success rate of our study was 70%.
Subject(s)
Drainage/methods , Emphysema/surgery , Pyelonephritis/surgery , Adult , Aged , Emphysema/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pyelonephritis/diagnostic imaging , Radiography, Interventional , Tomography, X-Ray Computed/methods , Treatment Outcome , Ultrasonography, Interventional , Urinary CatheterizationSubject(s)
Echinococcosis , Peritoneal Diseases , Aged , Albendazole/therapeutic use , Anticestodal Agents/therapeutic use , Drug Therapy, Combination , Echinococcosis/diagnostic imaging , Echinococcosis/drug therapy , Female , Follow-Up Studies , Humans , Peritoneal Diseases/diagnostic imaging , Peritoneal Diseases/drug therapy , Praziquantel/therapeutic use , Tomography, X-Ray Computed , UltrasonographySubject(s)
Cysts/congenital , Kidney/abnormalities , Seminal Vesicles/abnormalities , Adult , Cysts/diagnostic imaging , Humans , Male , UltrasonographyABSTRACT
Intrahepatic biliary cysts are rarely seen in the patients with biliary atresia. We describe a ten-month-old child with biliary atresia in whom the abdominal imaging studies (ultrasonography, computed tomographic scan and magnetic resonance cholangiopancreatography) revealed multiple intrahepatic biliary cysts ('bile lakes'). The child also had intrapulmonary shunting of blood due to pulmonary arteriovenous fistulae, which were demonstrated on contrast-enhanced echocardiography. Both these findings, 'bile lakes' and pulmonary arteriovenous fistulae occur rarely in biliary atresia.
Subject(s)
Biliary Atresia/diagnosis , Abdomen/diagnostic imaging , Arteriovenous Fistula/complications , Arteriovenous Fistula/diagnosis , Biliary Atresia/complications , Caroli Disease/diagnosis , Cholestasis/complications , Cholestasis/diagnosis , Diagnosis, Differential , Echocardiography , Humans , Infant , Male , Pulmonary Artery/abnormalities , Radiography, AbdominalABSTRACT
A case of metanephric adenoma occurring in a solitary kidney of a 31-year-old man is presented. Metanephric adenoma is extremely rare and its diagnosis should be considered in a patient with a well circumscribed renal tumour and concomitant paraneoplastic syndromes. Radiological features of the tumour are non-specific and histopathological examination is essential to establish a definitive diagnosis. Recognition of the tumour is of potential importance as conservative treatment with complete surgical enucleation will suffice in all cases.
