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Perirenalni absces: pregled literature in prikaz primera = Perirenal abscess: literature review and case reportHajdinjak, Tine ; Unuk, Sibila, 1973-Perirenalni absces (perinefrični ali obledvični ognojek) je gnojno vnetje med ledvično kapsulo in fascijo Geroto. Nastane lahko kot napredovanje okužbe v ledvici, hematogeno ali se razširi iz okolnih ... organov (debelo črevo, trebušna slinavka, medvretenčna ploščica,...). Absces se lahko širi preko fascije Gerote (pararenalni absces) ali navzdol po mišici psoas (absces mišice psoas). Pri renalnem abscesu so bolezenski znaki podobni kot pri akutnem pielonefritisu. Pri perirenalnem abscesu so simptomi in znaki pogosto neznačilni, saj gre za nejasno bolečino v trebuhu, splošno slabo počutje in anamnezo vročinskega stanja. Dejavniki tveganja so sladkorna bolezen, kronična obolenja jeter in oslabelost imunskega sistema. Obolenje ledvic (ledvični kamni, pionefros) je prisotno le pri polovici primerov. Zaradi nespecifičnih znakov pri dveh tretjinah bolnikov diagnoza perirenalnega abscesa ob sprejemu v bolnišnico ni jasna. Zato je potrebno pomisliti tudi na možnost perirenalnega abscesa in opraviti slikovne preiskave. Računalniška tomografija (CT) je v diagnostičnih postopkih zlati standard, ker je bolj natančna kot UZ sečil. Zdravljenje zajema uvedbo parenteralne antibiotične terapije, odstranitev morebitnega vzroka (npr. razrešitev zapore urina z nefrostomo) in podporno terapijo. Drenaža abscesa z radiološkimi metodami (ne samo aspiracija, temveč nastavitev drenažnih cevk) ali odprta kirurška drenaža je potrebna, če konzervativno zdravljenje ni uspešno ali če je absces večji od 3 - 5 cm. Opisali smo primer 57-letnega moškega z jetrno cirozo pri katerem so bili odkriti trije perirenalni abscesi v času zdravljenja v bolnišnici zaradi iztirjene novoodkrite sladkorne bolezni.Source: Okužbe urogenitalnega trakta : zbornik vabljenih predavanj in praktikum (Str. 117-128)Type of material - conference contribution ; adult, seriousPublish date - 2011Language - slovenianCOBISS.SI-ID - 3957823
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Database name | Field | Year |
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Hajdinjak, Tine | 19105 |
Unuk, Sibila, 1973- | 22301 |
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