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. 2007 Jul;23(3):250-2.
doi: 10.4103/0970-1591.33718.

Emphysematous pyelonephritis with calculus: Management strategies

Tanmaya Goel  1 , Sreedhar Reddy, Joseph Thomas
Affiliations

Emphysematous pyelonephritis with calculus: Management strategies

Tanmaya Goel et al. Indian J Urol. 2007 Jul.

Abstract

Objective: Emphysematous pyelonephritis (EPN) with calculus is well recognized but with very few reports on its treatment. Our aim is to elucidate our experience in its successful management.

Materials and methods: Over four years, we diagnosed seven cases (eight renal units) of EPN, out of which two patients (three renal units) had EPN with urinary calculi. After the initial conservative management of EPN, the stones were tackled appropriately.

Results: EPN was initially managed effectively with antibiotics and supportive care. Once the patient was stable, the stones were cleared in a step-wise fashion. The associated postoperative complications were also tackled efficiently with preservation of renal function.

Conclusion: In EPN with stones, nephrectomy is not the sole option available and they can be effectively managed with open / endoscopic measures.

Keywords: Calculus; emphysematous pyelonephritis; nephrectomy; nephron salvage; percutaneous drainage; percutaneous nephrolithotomy; stenting.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Computerized tomogram exhibiting bilateral EPN with renal calculi
Figure 2
Figure 2
Selective right renal angiogram depicting the bleeding vessel
Figure 3
Figure 3
Computerized tomogram showing left EPN with renal and upper ureteric calculi
See this image and copyright information in PMC

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