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Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature

Introduction: Emphysematous pyelonephritis is a rare and serious medical-surgical condition. Emergency nephrectomy is the standard treatment for forms that respond poorly to medical therapy, in conjunction with drainage of the upper excretory tract. Case report: This is a case of emphysematous pyelonephritis in a 54-year-old female patient who had presented with acute pyelonephritis, left renal colic and hyperactivity syndrome. A non-injected abdominopelvic CT scan revealed a globular, dedifferentiated left kidney with a diffuse aortic component. The right kidney was unremarkable. In intensive care, despite placement of a double JJ tube and antibiotic therapy with amikacin and cefotaxime, the patient's hemodynamic and neurological status continued to deteriorate, necessitating intubation. After 24 hours of well-managed treatment with no improvement, nephrectomy was performed in the setting of emphysematous destruction of the left kidney and persistent latent shock. Based on this observation and a review of the literature, we describe the clinical and radiological features, as well as the various diagnostic and therapeutic means of this condition. Conclusion: the diagnosis of emphysematous pyelonephritis should be suspected in the following cases: the presence of severe acute pyelonephritis, with no improvement in clinical condition despite well-conducted medical treatment or percutaneous drainage, or associated with signs of severity, particularly in diabetics, radical treatment is envisaged after failure of drug therapy.

Nephrectomy, Emphysematus Pyelonephritis, Diabtic, Hospital National Ignace Deen, Emergengy

APA Style

Bah Mamadou Bissiriou, Barry Mamadou Madiou, Barry Mamadou Dian, Diallo Thierno Oumar, Sow Thierno Amadou Oury, et al. (2023). Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature. International Journal of Clinical Urology, 7(2), 53-56. https://doi.org/10.11648/j.ijcu.20230702.16

ACS Style

Bah Mamadou Bissiriou; Barry Mamadou Madiou; Barry Mamadou Dian; Diallo Thierno Oumar; Sow Thierno Amadou Oury, et al. Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature. Int. J. Clin. Urol. 2023, 7(2), 53-56. doi: 10.11648/j.ijcu.20230702.16

AMA Style

Bah Mamadou Bissiriou, Barry Mamadou Madiou, Barry Mamadou Dian, Diallo Thierno Oumar, Sow Thierno Amadou Oury, et al. Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature. Int J Clin Urol. 2023;7(2):53-56. doi: 10.11648/j.ijcu.20230702.16

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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