PECULIARITIES OF PARANEPHRAL ABSCESSES WITHOUT OBSTRUCTIVE NEPHROPATHY
| Autor: | D. V. Shudrya, R. B. Savchenko, S.M. Panasenko |
|---|---|
| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії. 19:59-62 |
| ISSN: | 2077-1126 2077-1096 |
| DOI: | 10.31718/2077-1096.19.2.59 |
| Popis: | Until now the appropriateness of surgical tactics for paranephral abscess has been unquestionable. However, due to the improvement of visualizing techniques and wide clinical implementation of minimally invasive technologies, new prospects in the treatment of the disease are coming to light. The article demonstrates the peculiarities of aetiology, pathogenesis, diagnosis and treatment of 73 patients with perinephric abscess, which in most cases develops without being accompanied with obstructive nephropathy. Purulent inflammatory process in the paranephral fatty tissue without obstructive nephropathy was preceded by infectious inflammatory diseases of different localization, hypothermia and trauma. More often, purulent inflammation in the paranephral fatty tissue developed in patients with diabetes mellitus. Septic complications were seen in 80.8% of all cases. At the same time, in patients with diabetes mellitus, the complication rate was significantly higher. Based on the recommendations of the EAU, for starting therapy we used antibiotics, the sensitivity of uropathogens to which, according to the results of the local monitoring of the microbial landscape in the urological department exceeded 90%. After obtaining the results of bacteriological culture test, correction of antibacterial therapy was performed. Percutaneous drainage of a purulent focus was carried out under general anaesthesia with ultrasound guidance, according the Seldinger technique. Severe septic complications occurred in 80.8% of patients without obstructive nephropathy and in 86.3% of patients with obstructive nephropathy, more often in diabetics. Ultrasound and CT with contrast enhancement allow revealing a purulent focus in the paranephral fatty tissue with high probability. Percutaneous drainage has proven to be an effective method for the treatment of paranephral abscess. |
| Databáze: | OpenAIRE |
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