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Perinephric abscess secondary to a staghorn calculus presenting as a subcutaneous abscess

Published online by Cambridge University Press:  21 May 2015

Dylan Tsukagoshi ,
Bozanka Dinkovski ,
Sunil Dasan  and
Jalpesh Jethwa
Dylan Tsukagoshi*
Affiliation:
Emergency Department, East Surrey Hospital, Redhill, Surrey, United Kingdom
Bozanka Dinkovski
Affiliation:
Emergency Department, East Surrey Hospital, Redhill, Surrey, United Kingdom
Sunil Dasan
Affiliation:
Emergency Department, East Surrey Hospital, Redhill, Surrey, United Kingdom
Jalpesh Jethwa
Affiliation:
Emergency Department, East Surrey Hospital, Redhill, Surrey, United Kingdom
*
Radiology Department, Chelsea and Westminster Healthcare NHS Trust, 369 Fulham Rd., London UK SW10 9NH; dhayashi@doctors.org.uk

Abstract

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Perinephric abscesses often present with flank pain and signs of sepsis, and are known to discharge to the skin. We report a case of a young patient presenting with a 48-hour history of painful swelling in her right renal angle following a urinary tract infection and no overt signs or symptoms of sepsis. Plain abdominal films showed a perinephric abscess secondary to a staghorn calculus in the upper pole of the right kidney. On incision and drainage, 700 mL of pus was drained freely. The patient recovered well but required partial nephrectomy.

Subcutaneous abscess as a result of intra-abdominal pathology is a recognized but rare complication. This case illustrates that subcutaneous abscesses may have underlying intra-abdominal pathology without overt signs of sepsis.

Keywords

perinephricsubcutaneousabscesscalculus
Type
Case Report • Observations de cas
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 4 , July 2006 , pp. 285 - 288
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

References

1.Merimsky, E, Feldman, C. Perinephric abscess: report of 19 cases. Int Surg 1981;66:79–80.Google Scholar
2.Edelstein, H, McCabe, RE. Perinephric abscess. Modern diagnosis and treatment in 47 cases. Medicine (Baltimore) 1988;67:118–31.CrossRefGoogle ScholarPubMed
3.Deck, AJ, Yang, CC. Perinephric abscesses in the neurologically impaired. Spinal Cord 2001;39:477–81.CrossRefGoogle ScholarPubMed
4.Runyon, BA. Bacterial peritonitis secondary to a perinephric abscess. Case report and differentiation from spontaneous bacterial peritonitis. Am J Med 1986;80:997–8.CrossRefGoogle ScholarPubMed
5.Hutchison, FN.Kaysen, GA. Perinephric abscess: the missed diagnosis. Med Clin North Am 1988;72:993–1014.CrossRefGoogle ScholarPubMed
6.Thorley, JD, Jones, SR, Sanford, JP. Perinephric abscess. Medicine 1974;53:441–51.CrossRefGoogle ScholarPubMed
7.Dalla Palma, L, Pozzi-Mucelli, F, Ene, V. Medical treatment of renal and perirenal abscesses: CT evaluation. Clin Radiol 1999;54:792–7.CrossRefGoogle ScholarPubMed
8.Vaidyanathan, S, Hughes, PL, Soni, BM, et al. Unpredicted spontaneous extrusion of a renal calculusin an adult male with spina bifida and paraplegia: report of a misdiagnosis. Measures to be taken to reduce urological errors in spinal cord injury patients. BMC Urol 2001;1:3.CrossRefGoogle ScholarPubMed
9.Poulos, J, Johnson, SR, Conrad, P, et al. Dome-shaped lesion on chest radiograph: retroperitoneal abscess dissecting through the posterior chest wall. South Med J 1994;87:77–80.CrossRefGoogle ScholarPubMed
10.Cowley, JP, Connolly, CE, Hehir, M, et al. Renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in same kidney. Subcutaneous abscess of thigh asinitial presentation. Urology 1983;21:635–8.CrossRefGoogle ScholarPubMed
11.Mann, GN, Scoggins, CR, Adkins, B. Perforated cecal adenocarcinoma presenting as a thigh abscess. South Med J 1997;90:949–51.CrossRefGoogle ScholarPubMed
12.Arslan, N, Unal, N, Uzuner, N, et al. Pyogenic liver abscesses in a child spreading to pulmonary and subcutaneous tissues: case report. Turk J Pediatr 2004;46:279–82.Google Scholar
13.Peters, JH, Bleichrodt, RP, van Goor, H. A rare manifestation of perforated diverticulitis: parastomal subcutaneous abscess. Surg Infect (Larchmt) 2003;4:227–8.Google Scholar
14.Salvatierra, O Jr, Bucklew, WB, Morrow, JW. Perinephric abscess: a report of 71 cases. J Urol 1967;98:296–302.CrossRefGoogle ScholarPubMed