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KMID : 0352419920110040588
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Keimyung Medical Journal
1992 Volume.11 No. 4 p.588 ~ p.595
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Emphysematous Pyelonephritis: Treatment Options
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Abstract
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Emphysematous pyelonephritis is an uncommon and life-threatening, necrotizing renal parenchymal infection associated with gas-forming coliform bacteria.
Gas found only in the intrarenal collecting system has a favorable prognosis and is easily managed conservatively. Extensive parenchymal and perirenal infections present difficult problems managed by multimodality therapy with variable results.
It
occurs predominantly in diabetes and has a reported mortality rate of 40-90 percent. Fewer than 60 cases are reported with most authors recommending emergent nephrectomy or open drainage as treatment.
We have encountered 6 cases of emphysematous pyelonephritis during the last 2 years. Five cases were diabetics and another case was complicated ruptured kidney which has huge hydronephrosis with large upper ureteral stone. The patients were
managed
aggressively with fluids and antibiotics, or percutaneous drainage, followed by immediate nephrectomy in 4 cases and another 2 cases wee managed conservatively due to gas within the renal parenchyma and high operative risk, respectively.
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