scholarly journals Gas in the Kidney (Emphysematous Pyelonephritis) often Misdiagnosed as Colonic Gas

2016 ◽  
Vol 33 (2) ◽  
pp. 91-94
Author(s):  
Mohammad Ali Zulkifl ◽  
Mir Rasekh Alam
Keyword(s):  
Prognostic Factor ◽  
Characteristic Feature ◽  
Diabetic Patient ◽  
Ct Scan ◽  
Medical Management ◽  
Percutaneous Drainage ◽  
Emphysematous Pyelonephritis ◽  
Life Threatening ◽  
Prompt Diagnosis

Emphysematous pyelonephritis (EPN) is a serious and often life threatening infection of the renal and perirenal tissues. The characteristic feature of this infection is the presence of gas within the kidney and perinephric tissues. EPN usually occurs in diabetic women. CT Scan is the investigation of choice not only to establish the diagnosis but also to plan the line of management. Renal preservation must be the aim of management. This can be achieved to a great extent by medical management combined with percutaneous drainage of obstructed kidney. However nephrectomy is indicated in life threatening infection of the kidney. Prompt diagnosis and the timing of drainage could be the prognostic factor. A case of EPN in a diabetic patient who was successfully managed by nephrectomy is presented.J Bangladesh Coll Phys Surg 2015; 33(2): 91-94

scholarly journals Emphysematous pyelonephritis: a case report

2015 ◽  
Vol 9 (4) ◽  
pp. 370
Author(s):  
Fabrizio Tiratterra ◽  
Ludovica Feigusch ◽  
Chiara Villani ◽  
Patrizia Marchetti ◽  
Umberto Recine
Keyword(s):  
Medical Treatment ◽  
Medical Management ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Percutaneous Catheter Drainage ◽  
Catheter Drainage ◽  
Emphysematous Pyelonephritis ◽  
Percutaneous Catheter ◽  
Patients With Diabetes ◽  
Life Threatening

Emphysematous pyelonephritis is a severe, life-threatening, necrotizing kidney disease. It occurs almost exclusively in patients with diabetes mellitus. The clinical manifestations are those of pyelonephritis such as dysuria, fever, nausea, vomiting and abdominal pain. The diagnosis is radiological. The treatment strategies are controversial. They include medical management only, percutaneous catheter drainage plus medical management, emergency nephrectomy plus medical treatment or percutaneous drainage plus medical management and emergency nephrectomy. We present the case of a 68-year-old woman affected by emphysematous pyelonephritis successfully managed with conservative medical treatment.

scholarly journals Emphysematous pyelonephritis: is conservative management effective? Our experience and review of literature

2020 ◽  
Vol 7 (3) ◽  
pp. 849
Author(s):  
Atul Kumar Khandelwal
Keyword(s):  
Percutaneous Drainage ◽  
Early Stage ◽  
Abdominal Mass ◽  
Review Of Literature ◽  
Emphysematous Pyelonephritis ◽  
Life Threatening ◽  
Laboratory Investigations ◽  
Time Of Presentation ◽  
Time Of Admission

Background: Emphysematous pyelonephritis (EPN) is a urologic emergency caused by a life-threatening necrotizing infection of the kidney leading to an accumulation of gas in the renal parenchyma and perirenal tissue. we present the clinical details and outcome of twelve patients of managed at our institute and discuss their management and outcomes.Methods: Twelve consecutive patients with EPN were managed in our institute from July 2014 to July 2018. Data on demographic profile, clinical features, laboratory investigations, imaging studies, outcome of patients and follow up details were recorded.Results: Out of 12 patients with EPN, nine were female and three were male. Ten patients were diabetic (83%). All the diabetic patient had raised blood sugar at the time of admission ureteric stone was present in two nondiabetic patients. All the patients had fever at the time of presentation while localized flank pain was present in 6 (50%) patients. On examination, renal angle tenderness was present in ten patients while abdominal mass found in three patients. Pyuria was found in all patients while leukocytosis found in 10 patients. Two patients had thrombocytopenia while 4 had deranged renal parameters at the time of admission. Urine culture showed Escherichia coli in 8 patients and Klebsiella in two patients. Four patients required percutaneous drainage. Interval nephrectomy was done in one patient due to non-functioning kidney.Conclusions: Majority of patients diagnosed as emphysematous pyelonephritis were managed conservatively due to diagnosed at an early stage. Percutaneous drainage is successfully utilized in patients with more advanced disease.

scholarly journals Anaphylaxis – A guide to diagnosis, management and follow up

2002 ◽  
Vol 1 (2) ◽  
pp. 40-43
Author(s):  
Anthony P Williams ◽  
◽  
Thirumala Krishna ◽  
Anthony J Frew ◽  
◽  
...  
Keyword(s):  
Allergic Reaction ◽  
Medical Management ◽  
Previous Exposure ◽  
Life Threatening ◽  
Adults And Children ◽  
Ige Mediated ◽  
Prompt Diagnosis ◽  
Term Management

Anaphylaxis is a severe, potentially life threatening allergic reaction which occurs in adults and children. Prompt diagnosis and appropriate acute medical management will prevent fatal anaphylactic episodes. Anaphylactic reactions are IgE mediated responses to foreign antigens to which there has been previous exposure. The foreign antigens commonly implicated in anaphylaxis are foods (particularly nuts), drugs and venoms. Long term management should involve liaison with an immunologist/allergist to identify an underlying cause, provide education for further prevention and where possible offer immunotherapy.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Dynamic monitor of CT scan within short interval in invasive pulmonary aspergillosis for nonneutropenic patients: a retrospective analysis in two centers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Chen ◽  
Yonghong Zhong ◽  
Na Li ◽  
Huijie Wang ◽  
Yanbin Tan ◽  
...  
Keyword(s):  
Ct Scan ◽  
Respiratory Diseases ◽  
Short Interval ◽  
Invasive Pulmonary Aspergillosis ◽  
Host Factors ◽  
Antifungal Treatment ◽  
Ct Scans ◽  
Pulmonary Aspergillosis ◽  
European Organization ◽  
Life Threatening

Abstract Background In nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge. Methods A retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5–21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria (EORTC/MSG criteria). Results Together with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in the following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopsy. Conclusions Dynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

MO650EMPHYSEMATOUS PYELONEPHRITIS IN TYPE 2 DIABETES – CLINICAL PROFILE AND MANAGEMENT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Dr Sanjay Bhat ◽  
Anupma Kaul ◽  
Priyanka Rai ◽  
Rohit Srivastav
Keyword(s):  
Glycosylated Hemoglobin ◽  
Left Kidney ◽  
Diabetic Patients ◽  
Emphysematous Pyelonephritis ◽  
Medical College ◽  
Poor Outcome ◽  
Microbial Profile ◽  
Disturbance Of Consciousness ◽  
Life Threatening ◽  
High Index Of Suspicion

Abstract Background and Aims Emphysematous pyelonephritis (EPN) is a rare but life-threatening acute suppurative infection of the kidney among diabetics. There is no current consensus on management of EPN. Method A prospective observational study was conducted at Department of General Surgery at RML institute of Medical sciences , Lucknow as well as at Eras Lucknow medical college, Lucknow from 2015-2018 to look for clinical, microbial profile and treatment outcome of diabetic patients with emphysematous pyelonephritis. Results A total of 76 Diabetic patients diagnosed with pyelonephritis were identified, of which 15 patients were diagnosed with EPN (26.3%). The mean age of the patients was 58.4±6.5 years. Mean duration of diabetes was 5.3 ± 3.3 years. 12 (82%) of the 15 patients with DM had a glycosylated hemoglobin A1C level higher than 7.5. Renal dysfunction at presentation was seen in 11 (73.3%) patients. Among the unilateral involvement, left kidney was more affected. Escherichia coli in 11 (73.3%), Klebsiella sp. in 1 (6.6%), Pseudomonas in 1 (6.6%), and 1 each with polymicrobial and fungal UTI respectively. Of 15 EPN patients, 13 (86.6 %) survived and 1 (6.6 %) expired. 2 of them underwent nephrectomy both survived. All patients with Stage I, II and IIIa EPN (n = 12) were managed with antibiotics with or without PCD. In EPN Stage IIIb/IV (n = 3), all the 3 (20 %) patients were managed with antibiotics and PCD and later 2 (13.3%) needed nephrectomy. Only time to diagnosis, altered sensorium, shock at presentation and thrombocytopenia were associated with poor outcome in EPN patients (P < 0.05) Multiple logistic regression tests showed shock (P = .04) and and disturbance of consciousness (P = .05) on hospital admission as being the independent factors for poor outcome. Conclusion EPN in diabetics needs high index of suspicion, timely diagnosis and good multidisciplinary approach with adequate antibiotics and surgical management for better patient outcomes.

Management of an unusual cause of life-threatening haemoptysis: a multidisciplinary approach

2021 ◽  
Vol 14 (5) ◽  
pp. e240448
Author(s):  
Kim Pramanik ◽  
Philip Webb ◽  
RanaShoaib Hamid
Keyword(s):  
Cystic Fibrosis ◽  
Interventional Radiology ◽  
Tranexamic Acid ◽  
Medical Management ◽  
Multidisciplinary Approach ◽  
Bronchial Artery ◽  
Successful Resuscitation ◽  
Emergency Medical ◽  
Life Threatening

We present to you a case of life-threatening haemoptysis secondary to non-cystic fibrosis bronchiectasis complicated by bronchial artery pseudoaneurysms. We discuss this patient’s emergency medical management using intravenous tranexamic acid, which resulted in successful resuscitation and eventual survival, and evaluate the need for urgent anaesthetic and interventional radiology input in such a case.

Sign in / Sign up

Export Citation Format

Share Document