[Perinephritic abscesses: a review of 50 cases (author's transl)]

Accumulation of pus in the perinephritic cavity often gives rise to doubtful clinical manifestations, which hinder and delay prompt diagnosis of this severe process. The clinical, biological, radiological and therapeutic characteristics of 50 cases are reviewed; all were confirmed by either surgery or necropsy. The most frequent clinical manifestations were fever, lumbar pain and signs of localized inflammation. Biological data showed ESR elevation and left shift of leukocytes as the most constant finding. Pyelograms were abnormal in 90% with blurring of the psoas and contour of the kidney the most frequent finding. Gram-negative organisms were frequently isolated, with staphylococci accounting for 10%. Only surgical treatment had a definite effect on evolution. The mortality rate was high, due to incorrect or delayed diagnosis.