Renal and perinephric abscesses in West China Hospital:10-year retrospective-descriptive study

更新时间:2023-08-14

【摘要】AIM: To elucidate the clinical, radiological and laboratory profiles of renal abscess(RA) and perinephric abscess(PNA), along with related treatment and outcome.METHODS: Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identified from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition(ICD-10) codes(RA: N15.101, PNA: N15.102) between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients’ characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance profiles, treatment approaches, and clinical outcomes were collected and analyzed. RESULTS: The mean age of the patients was 46.49 years with a male to female ratio of 41:57. Lumbar pain(76.5%) and fever(53.1%) were the most common symptoms. Other symptoms and signs included chills(28.6%), anorexia and vomiting(25.5%), lethargy(10.2%), abdominal pain(11.2%), flank mass(12.2%), flank fistula(2.0%), gross hematuria(7.1%), frequency(14.3%), dysuria(9.2%), pyuria(5.1%) and weight loss(1.0%). Painful percussion of the costovertebral angle(87.8%) was the most common physical finding. The main predisposing factors were lithiasis(48.0%), diabetes mellitus(33.7%) followed by history of urological surgery(16.3%), urinary tract infections(14.3%), renal function impairment(13.3%), liver cirrhosis(2.0%), neurogenic bladder(1.0%), renal cyst(1.0%), hydronephrosis(1.0%), chronic hepatitis B(1.0%), post-discectomy(1.0%) and post-colectomy(1.0%). Ultrasound(US) and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice. Escherichia coli(51.4%), Staphylococcus aureus(10.0%) and Klebsiella pneumoniae(8.6%) were the main causative microorganisms. Intravenous antibiotictherapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and nonresponders. CONCLUSION: Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses.

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