Paranephritis

Description:

The paranephritis is an inflammatory process in a pararenal fatty tissue.

Paranephritis reasons:

Allocate a paranephritis primary and secondary. Primary results from the opened or closed injury of pararenal cellulose and penetration of an infection into it at wound or gematogenno from the remote centers of an infection. The paranephritis can develop not right after an injury, and after a while owing to development of inflammatory process in a hematoma zone at hematogenous penetration of an infection.

The secondary paranephritis develops as a complication of inflammatory process in a kidney. It arises at break of pus from a kidney in pararenal cellulose at abscess of a kidney or a pyonephrosis. Penetration of an infection into pararenal cellulose is possible in the hematogenous or lymphogenous way at pyelonephritis.

The chronic paranephritis develops at long inflammatory process in perinephric cellulose with its gradual fibrous regeneration and in most cases happens secondary, against the background of chronic inflammatory process in a kidney.

Paranephritis symptoms:

Clinically acute paranephritis is shown by fervescence to 39-40 °C with a fever. Other displays of a disease in the first few days can not be what frequent diagnostic mistakes are connected with. A condition of patients usually heavy with the phenomena of the expressed intoxication. Local displays of a disease in the form of a back pain and a painful palpation appear later 3-4 days. Existence of a so-called psoas symptome is possible. At the patient the leg on the party of defeat is bent in knee and coxofemoral joints and slightly given to a stomach. The attempt to unbend a leg leads to emergence of sharp pain in ileal area. It is connected with involvement in inflammatory process of a lumbar muscle.

At ultrasonography the liquid inclusions in perinephric cellulose which are the centers of purulent fusion can be found. In a survey picture of bodies of uric system are noted scoliosis towards defeat and lack of a contour of a poyasnichry muscle from this party. The excretory urography on a breath and an exhalation registers sharp restriction or total absence of mobility of a kidney on the party of defeat, at the same time uric ways are, as a rule, not changed. More exact data can be received at KT or MPT.

Treatment of a paranephritis:

Treatment of a paranephritis consists in purpose of antibacterial and disintoxication therapy in an initial phase of a disease, in the absence of obviously expressed centers of purulent fusion. At detection of the last and in case of inefficiency of conservative therapy surgery - drainage of a suppurative focus is shown. On condition of clinical performance drainage of a suppurative focus by means of establishment of a drainage tube or tubes by a transdermal puncture under ultrasonic control is admissible. At inefficiency of similar therapy opening of perinephric space, evacuation of purulent contents and drainage are made.
Treatment of a chronic paranephritis can be both conservative, and surgical. Conservative treatment consists in performing antiinflammatory, antibacterial and different resorptional therapy. Surgical treatment consists the changed fabrics around a kidney and an ureter or at a distance a kidney with the changed cellulose surrounding it depending on extent of change of a kidney at a distance.

The forecast at an acute paranephritis usually favorable, at chronic - depends on the course of inflammatory process in a kidney.