Successful nephrectomy after a failure of non-surgical treatment in emphysematous pyelonephritis: A case report
Terukumar Chandrasekaran,
Shirley Chong,
David Eng Yeow Gan,
Zainal Adwin Zainal Abidin,
Firdaus Hayati
Affiliations
Terukumar Chandrasekaran
Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
Shirley Chong
Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
David Eng Yeow Gan
Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
Zainal Adwin Zainal Abidin
Department on Surgery, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
Firdaus Hayati
Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; Department of General Surgery, Hospital Universiti Malaysia Sabah, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; Corresponding author.
Emphysematous pyelonephritis (EP) is an uncommon condition involving acute severe necrotising infection in the renal parenchyma, perinephric space and collecting system, with a mortality rate of up to 13%. A 62-year-old male with poorly controlled diabetes mellitus presented with severe epigastric pain and shortness of breath for three days. A computed tomography scan revealed class 3B EP, which failed medical therapy and percutaneous drainage. He underwent a nephrectomy and achieved an excellent clinical recovery. Septic shock and uncontrolled diabetes mellitus are two risk factors that lead to a poorer prognosis. Class 3B EP with failed medical therapy and percutaneous drainage would benefit from nephrectomy.
