A 42 Year Old Female with Pyonephrosis and Multiple Subcapsular Abscesses: Saving a Threatened Kidney

Abstract

Abstract Objective: The following report entails how the use of appropriate treatment and imaging leads to an excellent outcome. This description of dealing with a threatened kidney delineates the importance of critical thinking and application of least invasive techniques to provide optimum treatment and satisfaction to the patient, avoiding unnecessary loss of a viable kidney. Clinical Presentation: The following case is of a 42 year old woman, presenting with left loin pain and fever, eventually diagnosed to have a left obstructed kidney due to a Intervention: While in hospital, the patient received appropriate antibiotics, had a ureteric stent placed initially while the stone was manipulated into the left kidney, followed by drainage of two large subcapsular abscesses. Following discharge, during follow up she had the stent and stone removed rendering her symptom and stone free. CT was the imaging modality used in hospital and for follow up. Conclusion: When faced with multiple pathologies, such as our case, using gold standard imaging and tapering treatment to patient characteristics and needs, helped us tackle different pathologies in a step-wise manner with an excellent endpoint. The use of ureteric stenting, combined with percutaneous drainage of the subcaspular abscesses, was an excellent choice, one that saved the patient her left kidney