Abstract
Perinephric abscess in the past was associated with high morbidity and mortality rates. Standard therapy has included antibiotics and open surgical drainage. The advent of sonography and computed tomography has facilitated the diagnosis and treatment via percutaneous drainage. A retrospective search yielded 16 cases of perinephric abscesses at our institution between January 1980 and January 1990. Each case was evaluated with regard to age, sex, predisposing factors, diagnostic tests, treatment modality, morbidity and mortality. Seven patients underwent percutaneous drainage by either a Seldinger or trocar catheter techique. Six of these had successful drainage. The one unsuccessful case was a patient with an infected hematoma, which was treated successfully with open surgical drainage. Nine patients initially underwent open surgical drainage. Five also had nephrectomies for renal scan-documented nonfunctioning kidneys that contained renal caluli. Of the remaining four patients, one had a staghorn calculus and poor renal function and refused nephrectomy. She is doing well. The remaining three patients had good renal function. Two of these required further open surgical drainage. One had reaccumulation of the abscess, while the other had a septated abscess. We conclude that the notion of surgical drainage as the gold standard of therapy is no longer applicable given the success rate with percutaneous drainage. However, neither is percutaneous drainage to be considered the treatment of choice for all cases.
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