Pyonephrose : Risk factors, clinical, para-clinical and anatomopathological profile about 19 cases

Abstract

INTRODUCTION

Ponephrosis is a severe infection which is defined by the destruction of the renal parenchyma by a suppurative process within the dilated pyelocaliceal cavities. Suspected clinically but his diagnosis is mainly based on imagery. Despite clinical and radiological knowledge, it remains a surprise for the surgeon. The objective of this work is to describe the risk factors, the clinical, paraclinical and histological profile of it.

PATIENTS AND METHODS

We report a retrospective uni-centric study conducted from 02/2018 to 02/17/2020 including all the patients meeting the definition criteria. The data collected on pre-established cards were: age, risk factors, symptomatology, clinical examination data, para-clinical and anatomopathological examination results

RESULTS

Nineteen cases were listed, including 11 men and 08 women (M / F ratio at 1.37). The average age at diagnosis was 40 years (25-75 years). Urolithiasis was the most represented risk factor with 68.4% of the patients (Table 1). Low back pain was the most frequent reason for consultation (52.6%), infectious syndrome in 42.5% of cases. The clinical examination found lumbar contact in 63.1% of cases and a fistula in two cases. In 57.8% of patients, urine culture and pus samples had isolated a germ. Kidney function was impaired in 21% of patients. Ultrasound was diagnosed in 11 cases, but CT confirmed in all cases (Figure 1). All patients were treated with antibiotic therapy followed by subcapsular nephrectomy in 15 cases. Complicated post-operative infection in 5.2% of cases; chronic non-specific pyelonephritis was the most common form in 74% of cases

Conclusion

Urolithiasis, obstruction of the upper apparatus and diabetes are the main factors involved. The Euro-scanner plays a crucial role in the diagnosis. Drainage of the excretory pathway completed with cold nephrectomy gives good results. Non-specific chronic pyelonephritis is the most common histological form.