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Doctor's Information

Name :  Morteza
Family :Sanei Taheri
Affiliation : Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree: Associate Professor of Radiology
Email :   This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident :  ashraf sadat hoseini

Patient's Information

Gender :  Male
Age :  26

Case Section

Uroradiology & Genital Male Imaging

Clinical Summary

A 26 y/o man with right flank pain and fever

Imaging Procedures and Findings

Longitudinal ultrasound showes a hyperechoic mass-like lesion in lower pole of right kidney with collection in perinephric space. CTscan shows a rounded, heterogeneous mass with a poorly defined margin in right kidney with enhanced thick wall and septations and internal fluid density in perinephric space. Mild Inflammatory changes in the adjacent perinephric fat are also present.Under Sonography guided catheter drinage was done.

Discussion

If inadequately treated, acute pyelonephritis may progress to tissue necrosis, resulting in renal abscess. On contrastenhanced CT scans, renal abscesses usually have attenuation values of about 30 HU; this feature distinguishes them from fluid-density renal cysts.Their contents do not enhance. They may have distinct, rounded margins and thick, enhancing walls . Alternatively, abscesses may be ill-defined and surrounded by zones of decreased parenchymal enhancement, representing inflammation that has not yet progressed to necrosis. Gas is occasionally found in renal abscesses. Focal thickening of the adjacent renal fascia and stranding in the adjacent perinephric fat are common CT findings. Perinephric abscess may ultimately result if the infection extends through the renal capsule .

Final Diagnosis

renal abscess with extention to perinephric space caused by Staphylococcus aureus.

References

CT and MR imaging of the whole body / [edited by] John R. Haaga ... et al.].-5th ed.

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