2023 Volume 37 Issue 2 Pages 140-143
In treating multilocular emphysematous pyelonephritis with percutaneous drainage, the presence of septa often limits the effect of drainage. A case of multilocular emphysematous pyelonephritis successfully treated by multiple percutaneous drainage and septal destruction is reported.
A woman in her 70s was admitted for severe emphysematous pyelonephritis. Contrast-enhanced CT showed extensive multilocular lesions filled with gas in the right kidney. Conservative treatment including intravenous antibiotics was not sufficient, and percutaneous drainage was performed under fluoroscopic guidance. Due to the multilocularity, a single drainage catheter was inefficient, and three drainage catheters were placed. In addition, percutaneous septal destruction was performed with a hand-curved metal stylet that was inserted through a 6-Fr. sheath into the abscess and rotated to break the septa.
All drainage catheters were removed by 47 days, and emphysematous pyelonephritis was completely cured without surgery.
