DISCUSSIONRenal 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 1970’s- 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.

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