Clinical Characteristics and Treatment Outcome of Perinephric Abscess Treated in a Teaching Hospital

摘要

Perinephric abscess, have been associated with significant morbidity and mortality. A retrospectively, cross sectional study was designed in the tertiary level teaching hospital and reviewed all patients diagnosed to have perinephric abscess from the year 2001 until 2010. Perinephric abscess is a rare disease, with 21 cases documented over the period of 10 years. Female gender was found predominance, with male to female ratio 1:4.5. The incidence on the left side was higher than opposite side or bilateral. Most of them have 2 risk factors, including renal calculi (90%) and diabetes mellitus (66%). Of 21, 86% patients were presented with fever, and 47% of them have chills and rigors. Sixty three percent of the patient with perinephric abscess had white cell count ranged from 10-19 x 10~(9) cells/l. Urine cultures were positive in 18 (86%) of patients. From year 2007 onwards, all the cases suspected to have perinephric abscess for ulrasound were subjected to CT scan, which has increased the diagnostic sensitivity. Out of 21, 14 (66%) patients were treated with combination of antibiotics and percutaneous catheter drainage of the abscess. All patients were discharged eventually with one mortality. The clinical characteristics of perinephric abscesses have not changed significantly but improved imaging with CT allows increased diagnostic sensitivity. With accurate diagnosis, a variety of treatments can be successful, including antibiotics alone, or combination of antibiotics with percutaneous catheter drainage. In our series, there was only one patient posted for exploration and drainage. Essentially, this should be considered if adequate drainage is not achieved percutaneously.