Perinephric Abscess Causing Mycotic Celiac and Splenic Artery Aneurysm: A Case Report

Abstract

Perinephric abscess is a known complication of urologic infection, sometimes requiring surgical debridement. Extension into adjacent structures is rarely reported. We present a case of a woman with xanthogranulomatous emphysematous pyelonephritis accompanied by massive perinephric abscess, resulting in celiac and splenic artery mycotic aneurysms via direct invasion.

Keywords: emphysematous pyelitis; flank abscess; mycotic aneurysm; xanthogranulomatous pyelonephritis.

Figure 1. Non-contrast CT: Xanthogranulomatous emphysematous pyelonephritis w/large abscess

The top arrow identifies nephrolithiasis and emphysematous pyelonephritis. The bottom arrow identifies the associated perinephric abscess with extension into the pelvic cavity.

Figure 2. Contrast-infused CT: Subcutaneous extension of abscess with septation

The left arrow re-identifies the enlarging, and now septated, perinephric abscess with extension into the pelvic cavity. The right arrow identifies infiltration of abscess into the subcutaneous tissue external to the peritoneal cavity.