Pyonephrosis

Description:

The pyonephrosis is an end-stage is purulent - destructive process in a kidney owing to pyelonephritis. At the same time the kidney turns into the bag filled with pus, urine and products of fabric disintegration. Purulent process in a kidney extends to the fibrous capsule of body. Perinephric cellulose at the same time is exposed to cicatricial and sclerous changes, is densely soldered to a kidney and surrounding bodies that creates difficulties at operational treatment.

Pyonephrosis reasons:

Most often the pyonephrosis arises at an urolithiasis and the accompanying pyelonephritis. The importance in development of this disease plays disturbance of outflow of urine from the affected kidney that is a major factor in progressing is purulent - destructive changes and accumulation of pus in the struck body. There is also tubercular pyonephrosis.

Pyonephrosis symptoms:

The symptomatology consists of the constant dull aching ache in lumbar area, weakness, the subfebrile body temperature, weight loss. Some patients note release of muddy urine. Periodically there are aggravation periods when pain amplifies, body temperature increases, there are oznoba. At the same time urine opacification disappears. The periods of aggravations are connected with occlusion of an ureter and disturbance of outflow of urine and pus from the affected kidney.

Diagnosis:

Diagnosis. At a palpation the increased, slow-moving, moderately painful kidney is defined. Laboratory the leukocytosis, anemia, a hypoproteinemia, the expressed pyuria come to light.

At ultrasonography the affected kidney looks as one - or the multiband education with the thinned parenchyma filled with heterogeneous contents, which is usually including concrements. On excretory Urogramums the affected kidney does not excrete a contrast agent. At KT rough destructive changes in pyelocaliceal system and a parenchyma of a kidney at a pyonephrosis come to light most clearly. At a tsistoskopiya release of muddy urine or dense pus from the mouth of an ureter of the affected kidney as pastes from a tube can be noted.

Treatment of a pyonephrosis:

Treatment only surgical. At satisfactory condition of the patient the nephrectomy is carried out. In the presence of the phenomena of the expressed intoxication and serious condition of the patient with the first stage the transdermal puncture nephrostomy then antibacterial, antiinflammatory and disintoxication therapy is carried out is carried out. After improvement of a condition of the patient performance of a nephrectomy is possible.

Complications: break of pus in perinephric cellulose with development of a paranephritis, an urosepsis, an amyloidosis of an opposite kidney.

The forecast after a nephrectomy favorable though there is a danger of development of chronic pyelonephritis in the remained kidney.