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The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review
Renal and perirenal abscesses are very rare in children. They can be present as an acute emergency condition or insidiously as a chronic disease. The diagnosis is not so obvious, and it is a big challenge, especially when it can simulate a kidney tumor. The treatment can be conservative, preferably...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914655/ https://www.ncbi.nlm.nih.gov/pubmed/33572093 http://dx.doi.org/10.3390/medicina57020154 |
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author | Sosnowska-Sienkiewicz, Patrycja Bućko, Ewa Mańkowski, Przemysław |
author_facet | Sosnowska-Sienkiewicz, Patrycja Bućko, Ewa Mańkowski, Przemysław |
author_sort | Sosnowska-Sienkiewicz, Patrycja |
collection | PubMed |
description | Renal and perirenal abscesses are very rare in children. They can be present as an acute emergency condition or insidiously as a chronic disease. The diagnosis is not so obvious, and it is a big challenge, especially when it can simulate a kidney tumor. The treatment can be conservative, preferably with targeted antibiotics, or surgical, consisting primarily of drainage. This publication aims to present a clinical case in which both diagnosis and treatment were a big challenge for the entire treatment team. A 10-year-old male patient was admitted to the hospital because of mild abdominal pain and a temperature of 37.5 °C. The symptoms lasted for a week. In the computed tomography (CT), the lesion’s dimensions were 11.1 × 8.2 × 25 cm, and inflammation, abscess, cyst, and abdominal tumor have been suggested. The decision about surgical treatment was made. An enormous abscess near the right kidney was localized. The patient’s condition stabilized after surgery. Unfortunately, due to persistent purulent reservoirs, a second laparotomy was necessary. During the extensive diagnostic cystourethrography performed, vesicoureteral reflux was visualized. In conclusion, though a perinephric abscess is very rare in children, it should be taken into consideration in patients with non-specific abdominal symptoms. The imaging using ultrasound and CT scan with contrast enhancement is crucial to recognize and properly treat the condition. In terms of a small abscess, the only antimicrobial treatment using antibiotics of a broad spectrum can be considered. However, the drainage of an abscess, either percutaneous or open, should be used. For the large abscess, the open drainage seems to be a primary method of treatment. The importance of cooperation in a multidisciplinary team is crucial, as the diagnosis and treatment of underlying causes are essential. |
format | Online Article Text |
id | pubmed-7914655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79146552021-03-01 The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review Sosnowska-Sienkiewicz, Patrycja Bućko, Ewa Mańkowski, Przemysław Medicina (Kaunas) Case Report Renal and perirenal abscesses are very rare in children. They can be present as an acute emergency condition or insidiously as a chronic disease. The diagnosis is not so obvious, and it is a big challenge, especially when it can simulate a kidney tumor. The treatment can be conservative, preferably with targeted antibiotics, or surgical, consisting primarily of drainage. This publication aims to present a clinical case in which both diagnosis and treatment were a big challenge for the entire treatment team. A 10-year-old male patient was admitted to the hospital because of mild abdominal pain and a temperature of 37.5 °C. The symptoms lasted for a week. In the computed tomography (CT), the lesion’s dimensions were 11.1 × 8.2 × 25 cm, and inflammation, abscess, cyst, and abdominal tumor have been suggested. The decision about surgical treatment was made. An enormous abscess near the right kidney was localized. The patient’s condition stabilized after surgery. Unfortunately, due to persistent purulent reservoirs, a second laparotomy was necessary. During the extensive diagnostic cystourethrography performed, vesicoureteral reflux was visualized. In conclusion, though a perinephric abscess is very rare in children, it should be taken into consideration in patients with non-specific abdominal symptoms. The imaging using ultrasound and CT scan with contrast enhancement is crucial to recognize and properly treat the condition. In terms of a small abscess, the only antimicrobial treatment using antibiotics of a broad spectrum can be considered. However, the drainage of an abscess, either percutaneous or open, should be used. For the large abscess, the open drainage seems to be a primary method of treatment. The importance of cooperation in a multidisciplinary team is crucial, as the diagnosis and treatment of underlying causes are essential. MDPI 2021-02-09 /pmc/articles/PMC7914655/ /pubmed/33572093 http://dx.doi.org/10.3390/medicina57020154 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Sosnowska-Sienkiewicz, Patrycja Bućko, Ewa Mańkowski, Przemysław The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review |
title | The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review |
title_full | The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review |
title_fullStr | The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review |
title_full_unstemmed | The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review |
title_short | The Rare Case of Perirenal Abscess in a Child—Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review |
title_sort | rare case of perirenal abscess in a child—possible mechanisms and methods of treatment: a case report and literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914655/ https://www.ncbi.nlm.nih.gov/pubmed/33572093 http://dx.doi.org/10.3390/medicina57020154 |
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