1/24. Multiple renal aspergillus abscesses in an AIDS patient: contrast-enhanced helical CT and MRI findings.renal insufficiency or allergic reactions for X-ray contrast agents are frequent limitations in immunocompromised hosts such as neutropenic or AIDS patients. Due to a better tolerance of contrast agents in MRI, this technique is well suited for investigation of parenchymal organs. We demonstrate an allergic AIDS patient who presented with fever and flank pain. At sonography, anechoic renal lesions were supposed to be non-complicated cysts; however, on T2-weighted MRI, the center was of high signal. Dynamic contrast-enhanced MRI of the kidneys demonstrated an enhancing rim with ill-defined margins. The lesions were supposed to be multiple bilateral abscesses. Due to the multiple dynamic contrast series, a delayed enhancement of renal parenchyma was detectable adjacent to the lesion. This was suggested as accompanying local pyelonephritis and an infectious etiology became more reliable. aspergillus fumigatus was identified by CT-guided biopsy as the underlying microorganism. The MR appearance of this manifestation has not been described previously.- - - - - - - - - - ranking = 1keywords = flank pain, flank (Clic here for more details about this article) |
2/24. Right perinephric abscess: a rare presentation of ruptured retrocecal appendicitis.Perinephric abscess commonly arises from rupture of an intrarenal abscess into the perinephric space. It rarely results from gastrointestinal pathology. We report two pediatric patients with retrocecal appendicitis that presented with perinephric abscess. A 3-year-old girl presented with high fever and right flank pain for more than 1 week. ultrasonography showed a right perinephric fluid collection with normal renal parenchyma and collecting system. A perinephric abscess extending from a ruptured retrocecal appendix was diagnosed by abdominal computed tomographic (CT) scan. Her hospital course was complicated with empyema, peritonitis, and pericardial effusion. A 6-year-old girl had lower abdominal pain for 3 days and high fever on the day of admission. ultrasonography showed a right perinephric abscess with a normal renal contour and a fecalith in the enlarged appendix in the right lower quadrant of the abdomen. appendectomy and drainage of the perinephric abscess were performed in both cases. We suggest that a ruptured retrocecal appendix must be considered in cases of perinephric abscess, especially in patients with gas bubbles in the abscess and a normal urogenital appearance. ultrasonography and abdominal CT scan are the preferred diagnostic tools. Prolonged antibiotics and drainage of the abscess are mandatory to decrease morbidity and mortality.- - - - - - - - - - ranking = 0.30144038484102keywords = flank (Clic here for more details about this article) |
3/24. Puerperal adrenal abscess complicating chorioamnionitis.BACKGROUND: An abscess in the adrenal gland is a rare finding described only a few times in the literature. We present a case report of chorioamnionitis complicated by a puerperal adrenal abscess diagnosed and drained percutaneously using ultrasound and computed tomography. CASE: A 22-year-old woman delivered prematurely because of chorioamnionitis. amoxicillin clavulanate was administered, and her fever defervesced. Six days later, the patient presented with a temperature of 40C and right flank pain. Workup revealed an abscess in the right adrenal gland, which was diagnosed by computed tomography scan, and then drained percutaneously. Follow-up revealed regression of the abscess to complete recovery. CONCLUSION: Adrenal abscess has not been described in the past as a possible complication of choriamnionitis. It is important to assess the entire abdominal cavity by ultrasound or computed tomography in febrile patients who do not respond to medical therapy.- - - - - - - - - - ranking = 1keywords = flank pain, flank (Clic here for more details about this article) |
4/24. Spilled gallstones after laparoscopic cholecystectomy.Spilled gallstones have emerged as a new issue in the era of laparoscopic cholecystectomy. We treated a 77-year-old woman who underwent laparoscopic cholecystectomy. Subsequently, a right flank abscess developed. During the cholecystectomy, the gallbladder was perforated and stones were spilled. After a failed attempt to drain the abscess percutaneously, the patient required open drainage, which revealed retained gallstones in the right flank. The abscess resolved, although the patient continued to have intermittent drainage without evidence of sepsis. review of the literature revealed 127 cases of spilled gallstones, of which 44.1% presented with intraperitoneal abscess, 18.1% with abdominal wall abscess, 11.8% with thoracic abscess, 10.2% with retroperitoneal abscess, and the rest with various clinical pictures. In case of gallstone spillage during laparoscopic cholecystectomy, every effort should be made to locate and retrieve the stones.- - - - - - - - - - ranking = 0.60288076968204keywords = flank (Clic here for more details about this article) |
5/24. The clinical spectrum of chronic appendiceal abscess in cystic fibrosis.OBJECTIVE--To describe the varied characteristics seen in patients with cystic fibrosis who develop chronic abscess formation secondary to unrecognized appendicitis. DESIGN--Patient series. SETTING--cystic fibrosis Care Centers in Columbus, ohio, and Tucson, Ariz. PARTICIPANTS--Five patients with cystic fibrosis who developed chronic abdominal abscesses secondary to occult appendicitis are described. Two patients developed fistula formation with purulent fluid drainage before diagnosis. One patient developed an extensive psoas abscess. Another presented with prolonged fever of unknown origin. These patients were identified by retrospective review of the past 20-year experience at two cystic fibrosis Care Centers. CONCLUSIONS--Development of chronic abdominal abscess related to unrecognized appendicitis is a rare but important complication in patients with cystic fibrosis. Prompt diagnosis depends on physician familiarity with the varied presentations of this entity. Diagnostic abdominal computed tomography and/or ultrasonography should particularly be considered when patients with cystic fibrosis present with pain, mass, or drainage from the right flank; prolonged fever; a limp; or failure of suspected meconium ileus equivalent syndrome to respond promptly to cathartic measures.- - - - - - - - - - ranking = 0.30144038484102keywords = flank (Clic here for more details about this article) |
6/24. Metastatic renal abscess mimicking Wilms' tumour.Renal abscesses are uncommon in children, and usually present with a high fever and flank pain. We report a 9-year-old girl who presented with abdominal pain and cough. While the finding of multiple lung nodules and a renal mass prompted the initial diagnosis of Wilms' tumour, biopsy showed multiple renal abscesses with secondary lung involvement. The imaging findings and pathology correlation are provided.- - - - - - - - - - ranking = 1keywords = flank pain, flank (Clic here for more details about this article) |
7/24. Renal abscess in healthy children: report of three cases.We report three cases of renal abscess in otherwise healthy boys. One had a history of blunt trauma and two of antecedent skin infection. All presented with flank pain and fever. urine and blood cultures were sterile. The diagnosis was made using ultrasound and computerized axial tomography. The first patient had recurrent renal abscess, following surgery and a short course of antibiotics. Eventually all responded well to long-term antibiotics only.- - - - - - - - - - ranking = 1keywords = flank pain, flank (Clic here for more details about this article) |
8/24. Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: an extremely fulminant form of a common disease.As a disease commonly encountered in daily practice, acute appendicitis is usually diagnosed and managed easily with a low mortality and morbidity rate. However, acute appendicitis may occasionally become extraordinarily complicated and life threatening. A 56-year-old man, healthy prior to this admission, was brought to the hospital due to spiking high fever, poor appetite, dysuria, progressive right flank and painful swelling of the thigh for 3 d. Significant inflammatory change of soft tissue was noted, involving the entire right trunk from the subcostal margin to the knee joint. Painful disability of the right lower extremity and apparent signs of peritonitis at the right lower abdomen were disclosed. Laboratory results revealed leukocytosis and an elevated c-reactive protein level. Abdominal CT revealed several communicated gas-containing abscesses at the right retroperitoneal region with mass effect, pushing the duodenum and the pancreatic head upward, compressing and encasing inferior vena cava, destroying psoas muscle and dissecting downward into the right thigh. laparotomy and right thigh exploration were performed immediately and about 500 mL of frank pus was drained. A ruptured retrocecal appendix was the cause of the abscess. The patient fully recovered at the end of the third post-operation week. This case reminds us that acute appendicitis should be treated carefully on an emergency basis to avoid serious complications. CT scan is the diagnostic tool of choice, with rapid evaluation followed by adequate drainage as the key to the survival of the patient.- - - - - - - - - - ranking = 0.30144038484102keywords = flank (Clic here for more details about this article) |
9/24. Absent Tc-99m ciprofloxacin (infecton) uptake in a renal abscess.A 40-year-old male diabetic presented with a 1-month history of flank pain, fever, and chills. Examination revealed pyrexia and left flank tenderness. Pus and red cells were seen on urine microscopy and klebsiella was isolated from the urine. The patient was treated with antibiotics, but the fever persisted and he was sent for an Infecton scan that showed a large cold area in the superolateral aspect of the left kidney. Whole-body imaging failed to reveal any other abnormal site. Computed tomography (CT) demonstrated a space-occupying lesion with an air-fluid level in the upper part of the left kidney. The patient responded to several weeks of antibiotic therapy.- - - - - - - - - - ranking = 1.301440384841keywords = flank pain, flank (Clic here for more details about this article) |
10/24. Renal abscess.This study analyses the pre-disposing factors, diagnostic modalities, therapeutic options and prognostic factors involved in 7 subjects with renal abscess. Most often they presented with high fever and flank pain. USG and CT were used to establish the diagnosis. urine culture yielded organisms in five cases and hence empirical antibiotic therapy for Gram-negative organism was offered. Complicated abscess in our series carried high mortality especially in immuno suppressed and cachectic patients.- - - - - - - - - - ranking = 1keywords = flank pain, flank (Clic here for more details about this article) |
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