Perirenal Abscess

Perirenal Abscess

Perirenal abscess is defined as an infectious condition characterized by formation of abscess surrounding kidneys. It is a complication of urinary tract infection. This leads to collection of pus surrounding the kidneys.

Causes and risk factors

It is caused by bacterial infection. Risk factors associated are urinary tract infection, diabetes, renal stones, renal trauma, obstructive tumor, benign cyst, polycystic kidney disease, vesicoureteral reflux. Any operative procedure on kidneys can also lead to perirenal abscess. Rupture of corticomedullary or cortical abscesses result in perinephric collection or abscesses.

Clinical presentation

Patient presents with symptoms like pain in flanks, burning while urination, frequent urination. Symptoms of urinary tract infection are present. There is presence of blood in urine.  Fever with chills occurs. In case of perirenal abscess, it is observed that there is no improvement with antibiotics given for urinary tract infection.

Investigations

Medical history by the patient and clinical examination by the doctor helps in diagnosis. Routine blood tests like CBC are done. Urine routine, urine culture is required. USG abdomen and pelvis is recommended. Imaging studies such as chest x-ray, CT scan may be useful for further evaluation.

Treatment

Treatment is aimed at clearing infection & drainage of pus. Antibiotics, analgesics & antipyretics are given. Abscess is drained through a catheter that is placed through the skin or with surgery.

Complications

Complications such as spread of infections leading to peritonitis can take place. Nephritis, pyelonephritis, septicemia may occur.

When to Contact a Doctor  

One must consult a doctor if there is severe pain in flanks or loin, burning urination, increased frequency of urination.

Prevention

Key is to prevent urinary tract infection & kidney stones or treat them at the earliest.

Systems involved

Urinary system

Organs involved

Kidneys, bladder, ureters, urethra

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