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[Acute abdomen masking pyelonephritis (author's transl)]
MMW, Munchener Medizinische Wochenschrift
|February 20, 1976
Summary
Acutely exacerbated pyelonephritis can mimic an acute abdomen, leading to unnecessary surgery. Recognizing specific symptoms like fever and abnormal urinalysis is key to diagnosing this "abdominal type" of kidney infection.
Area of Science:
- Nephrology
- Urology
- Surgical Gastroenterology
Background:
- Acute pyelonephritis, a kidney infection, can present with symptoms mimicking acute abdominal conditions.
- Differential diagnosis is crucial to avoid unnecessary surgical interventions.
Observation:
- Analysis of 10 case histories revealed that acute pyelonephritis can manifest as an acute abdomen.
- Visceral reflexes (viscero-dermal and visero-visceral) can cause pain, hyperalgesia, muscular defense, shock, vomiting, and altered intestinal motility.
- Metabolic acidosis, hyperchloremia, fever, and abnormal urinalysis were observed.
Findings:
- The clinical presentation of acute pyelonephritis can strongly resemble an acute abdomen, leading to consideration of laparotomy.
- Specific signs such as fever, pathological urinalysis, renal acidosis, and hyperchloremia are indicative of the 'abdominal type' of acutely exacerbated pyelonephritis.
Implications:
- Accurate diagnosis of the 'abdominal type' of pyelonephritis can prevent unnecessary exploratory laparotomies.
- Clinicians should consider pyelonephritis in the differential diagnosis of acute abdominal pain, especially when accompanied by fever and urinalysis abnormalities.
- Early recognition improves patient outcomes by enabling appropriate antibiotic treatment instead of surgical intervention.