Giant Pyonephrosis in an Ectopic Kidney: A Case Report

Pyonephrosis is characterized by infective hydronephrosis accompanied by suppurative destruction of the renal parenchyma, resulting in partial or complete impairment of renal function. Patients present with wide range of symptoms, they can be asymptomatic in 15% but most of them present with septic features like fever, chills, and flank pain. Urinary tract infections, functional and anatomic obstruction, and anatomic anomalies such as pelvic and horseshoe kidneys are common etiologic factors. We report a 30 years old female patient with giant pyonephrosis in an ectopic kidney. She presented with acute toxic symptoms after she has been experiencing progressive abdominal swelling and pain for a couple of years. Simple nephrectomy was done four weeks after she has been initially treated with percutaneous drainage of the pus and intravenous antibiotics.

Giant bladder stone resulting in acute kidney injury; A case report and review of literature

A giant bladder stone is very rare in adults. We report a case of giant bladder stone causing acute kidney injury in a 23-year-old male, who presented with lower urinary tract symptoms (LUTS) characterized by both irritative and obstructive LUTS. In addition, he also had episodes of reddish urine for the past decade. A non-contrast-enhanced CT scan was used for the diagnosis. Open cystolithotomy was performed and a 500g weighing stone was removed. He developed a superficial surgical site infection which was treated with wound care. He was discharged improved. Improvement in symptoms and serum creatinine was noted on follow-up.

Conservative Management of the Duodenal Injury during Percutaneous Nephrostomy Placement: A Few and Far between Complications of the Urological Literature

Herein, we reported a duodenal perforation case as an intestinal injury during a percutaneous nephrostomy procedure. A 73-year-old woman with bilateral nephrostomy catheters was applied to the emergency service with right flank pain. Early in the day, her bilateral nephrostomy catheters had been changed. On physical examination, she had a defense and rebound at her right quadrant, and costovertebral angle tenderness was also positive. In the contrast-enhanced abdominal computed tomography scan, the right nephrostomy catheter was located in the second part of the duodenum, and the contrast agent did not leak into the peritoneum from the injury area. We decided on conservative management of the case with active surveillance using daily blood tests and physical examinations. The nephrostomy catheter in the duodenum was left to prevent fistula between the duodenum and the skin, and a new one was placed in the right kidney. The broad spectrum antibiotherapy regime was applied, and the patient was followed up closely. The catheter in the duodenum was removed on the 20th day, uneventfully, and the patient was discharged successfully on the 24th day with her permanent bilateral nephrostomy tubes. On the first follow-up, one month later, the patient had no active medical complaint.