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Pyonephrosis: imaging and intervention.

I C Yoder, R C Pfister, K K Lindfors

AJR. American Journal of Roentgenology

|October 1, 1983

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Radiologic imaging aids in diagnosing pyonephrosis, a kidney infection. Percutaneous nephrostomy catheter drainage is effective for treating infection and preserving kidney function.

Area of Science:

Nephrology
Radiology
Urology

Background:

Pyonephrosis, a severe kidney infection, presents with fever and flank pain.
Diagnosis is suspected with clinical symptoms and radiologic evidence of urinary tract obstruction.

Purpose of the Study:

To evaluate the role of radiologic imaging in diagnosing pyonephrosis.
To assess the diagnostic and therapeutic utility of percutaneous nephrostomy catheter drainage.

Main Methods:

Retrospective analysis of 70 pyonephrotic kidneys treated with percutaneous nephrostomy.
Sonography for hydronephrosis diagnosis, needle aspiration for pus confirmation.
Percutaneous nephrostomy catheter insertion for drainage and function evaluation.

Main Results:

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Sonography and needle aspiration confirmed pyonephrosis.
Nephrostomy catheter facilitated drainage, diagnostic procedures (nephrostograms, ureteral perfusions), and stone dissolution.
In 10 azotemic patients, nephrostomy drainage and antibiotics normalized renal function (blood urea nitrogen, serum creatinine).
Long-term follow-up in 26 patients showed preserved function in 25 previously pyonephrotic kidneys.

Conclusions:

Radiologic imaging is crucial for pyonephrosis diagnosis.
Percutaneous nephrostomy is a valuable tool for diagnosis, drainage, and management of pyonephrosis, aiding in preserving renal function.