Search this website:
Review literature: (Angel et al, 2003) (Shu et al, 2004).
A perinephric abscess is a collection of pus within Gerota's fascia.
Before the antibiotic era, perinephric abscesses were often caused by the hematogenous spread of staphylococci. Today's risk groups for hematogenous spread of staphylococci: intravenous drug abuse, intensive care, dialysis patients, valvular heart disease and endocarditis.
.In contrast to a renal abscess, signs and symptoms of a perinephric abscess have a slow onset and are unspecific. Patients present usually with symptoms of more than one week, complaining about fever, flank pain or abdominal pain, night sweat and chills. More than 30% are afebrile.
Urine culture is not sensitive and can identify the responsible bacteria in only 30%.
Blood culture (positive in 50%). Blood count, coagulation tests, CRP, liver enzymes, creatinine. In suspected urosepsis, determination of sepsis parameters such as blood gas testing, AT III and fibrinogen.
Sonographic signs for a perinephric abcess in renal ultrasound are a perirenal hypoechoic area, which may have inclusion of air (echogenic reflex with dorsal shadowing).
CT is the diagnostic test of choice [fig. perinephric abscess]. The perinephric abscess appears as a hypodense area. Air inclusion is possible. After administration of contrast media, there is an ring-like enhancement of the abscess capsule.
![]() |
CT of a right-sided perinephric abscess: (left horizontal plane, right sagittal reconstruction). The patient complained about night sweats and fatigue, he had no flank pain or fever. With kind permission of Prof. Dr. K. Bohndorf, Augsburg. |
Intravenous urography is not very helpful in suspected perinephric abscess. If done, KUB x-ray may show an absent psoas shadow, a perinephric mass, retroperitoneal air surrounding the kidney and nephrolithiasis. The excretion of contrast media is often without pathological findings.
Treatment consists of parenteral antibiotics and abscess drainage:
Renal abscess | Index | Kidneys |
You did not find what you are looking for?
Search this site with Google:
Deutsche Version: Perinephritischer Abszess
Last update
© Dr. med. Dirk Manski
man...@urologielehrbuch.de