Abstract

"Purpose: To compare the differences between renal abscess and perirenal abscess in causes, clinical courses, treatment method and their outcome. Material and methods: From January 2001 to July 2008, we retrospectively reviewed the medical records of 66 patients who were diagnosed and treated for renal and perirenal abscess at our center. Seventy-one kidneys were involved. Renal and perirenal abscess were 40 and 31 cases, respectively. We divided 2 groups and analyzed patients characteristics, symptoms, underlying diseases, pathogenic organisms, abscess size, treatment duration, and clinical outcome. Results: The average age of the patients was 47.9 years and female was predominant (M:F=1:2.9) (p= 0.0009). Diabetes mellitus (33.8%), liver cirrhosis (19.7%) and kidney diseases (19.7%) were the most common predisposing factors. Diabetes mellitus was more frequently combined with perirenal abscess group (p=0.0419). The symptom-diagnosis duration and hospitalized period of perirenal abscess group were longer than those of renal abscess group (13.5±14.9 vs 8.3±9.9days and 26.5±21.1 vs 13.5±14.9 days; p=0.0823 and 0.0005, respectively). Escherichia coli, Staphylococcus aureus, Klebsiella pneumonia were common pathogens in two group. The mean size of the renal and perirenal abscess were 2.85cm (range 1~7.7) and 5.84cm (range 1.5~13) (p<0.0001). Most of the renal abscesses received only antimicrobial agents (75%) and were cured on discharge. However, 22 cases in 31 perirenal abscess (71%) were needed an interventional treatment: needle aspiration 6 (19.4%), percutaneous drainage 15 (45.2%), open drainage 1 (3.2%), nephrectomy 1 (3.2%). Mortalities of renal and perirenal abscess were 2.7% (1/37) and 13.8% (4/29) (p=0.222), respectively. Conclusions: There were significant differences between renal abscess and perirenal abscess in their size, treatment strategies, period of treatment, clinical outcome. On comparison with renal abscess, perirenal abscess was bigger, more aggressive treated, longer hospitalized, and more fatal. We must consider their dissimilarities in treatment."

• Keywords: Abscess, Kidney