DISCUSSION

Renal

abscess is a collection of
purulent material confined to the
renal parenchyma.
Majority are caused by gram
negative,ascending urinary tract
infections.

PREDISPOSING FACTORS
Diabetes

mellitus
Renal stones
Renal obstruction
Renal insufficiency
Multisystem disease

MANAGEMENT
The

classic management of renal abscess has been

surgical exploration with incision and drainage OR
Nephrectomy
1994- Fowler and Perkins; 80% were treated with
primary open surgery, an additional 4 required
secondary surgery for failure to improve after
initial percutaneous drainage

MGT CONTD
1970s-

management with antibiotics alone or in

combination with percutaneous drainage
1996 Seigel and colleagues treated patients
successfully(87%) with Percutaneous drainage
and/ or antibiotics
CT-guided Percutaneous drain placement
techniques are widely available with rare
complications

MGT CONTD
Drain

can be placed in a small, focal renal abscess

and perinephric or paranephric spaces(if they
become involved).
Apparent multiloculations can be adequately
drained with a single drainage catheter because
intercommunications are not always apparent on
CT.

MGT CONTD
Conservative mgt of renal abscess with Percutaneous
drainage and antibiotics offers several advantages
Surgical intervention in acute stages poses risk for patients
with sepsis and haemodynamic instability
Drainage allows for a well planned urgent and elective
operation that allows correction of underlying,contributing
conditions
Also permits nephron sparing in selected cases

CONCLUSION
In

selected cases iv antibiotics alone or in

combination with Percutaneous drainage may be
the preferred therapy
Percutaneous drainage is a safe,effective
alternative to open surgical drainage
When percutaneous drainage is not curative, it
allows time for stabilization of the patient and
safer surgery.

THANK YOU