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2016 ; 25
(ä): 151
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gab.com Text
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Le traitement conservateur de la pyélonéphrite emphysémateuse chez les patients
diabétiques: à propos de cinq observations
#MMPMID28292113
El Majdoub A
; Khallouk A
; Farih MH
Pan Afr Med J
2016[]; 25
(ä): 151
PMID28292113
show ga
Acute emphysematous pyelonephritis (EPN) is a severe kidney infection. Early and
effective treatment is essential to reduce high mortality rates due to this
disease. Our study aims to highlight the clinical and paraclinical features as
well as the peculiarities of therapeutic management of this disease and focus on
the possibility of conservative treatment in diabetic patients. We analyzed the
medical records of patients with EPN treated in the Department of Urology at the
Hassan II University Hospital, Fez between January 2004 and January 2010. For
each medical record we described clinical, paraclinical and therapeutic features
as well as patient's evolution after treatment. We here report the case of 5
female patients whose average age was 45,6 years. All patients were diabetic.
Lithiasic obstruction of the upper urinary tract was found in 3 patients (60%).
The diagnosis was made by means of abdominal CT scan. All patients underwent
resuscitation measures including antibiotic and insulin therapy. Conservative
surgical procedure was performed in all cases. Indeed, surgical drainage of
perirenal collections was performed in two cases, percutaneous renal drainage in
one case and drainage using double-J ureteral catheter in 2 cases. Clinical and
radiological evolution was excellent with renal preservation in all patients
Emphysematous pyelonephritis is a rare and serious complication, especially in
diabetic patients. Diagnosis is based on CT scan. Surgical treatment should be
conservative in most cases, apart from severe forms, especially in diabetic
patients who have potential risk of chronic renal failure.