Abstract

"Purpose: The therapeutic approaches to patients with emphysematous pyelonephritis remain controversial. We evaluated the usefulness of percutaneous drainage and broad-spectrum antimicrobials in patients with emphysematous pyelonephritis. Materials and Methods: From January 2001 to May 2010, 17 patients (14 females and 3 males) with emphysematous pyelonephritis (EPN) were managed at our institution. We retrospectively reviewed patient characteristics, causative pathogens, treatment methods, hospital stay duration, and treatment outcomes. The diagnosis of EPN was confirmed by the presence of intraparenchymal and/or perinephric gas burbles in imaging studies. Treatment modalities were consisted of emergency nephrectomy in 7 patients (Group A), percutaneous renal drainage in 6 patients (Group B) and medical therapy only in 4 patients (Group C). Results: The mean age of total patients was 58.4±14.8 (38-84) years. The most common underlying disease was diabetes. Serum blood sugar levels were not appropriately controlled in 12 among 14 diabetics. The cure rates and mean hospital stay in Groups A, B and C were 85.7%, 83.3%, and 30 days, 12 days, respectively. The mortality rates were 50% in type I and 37.2% in type II, according to the computed tomography findings. Conclusions: Combining broad-spectrum antibiotic therapy with percutaneous renal drainage is a safe and effective treatment of emphysematous pyelonephritis, especially in high-risk patients for whom nephrectomy under general anesthesia are not feasible."

• Keywords: Emphysematous, Pyelonephritis, Nephrectomy, Percutaneous, Drainage