Forgotten DJ stent presenting with emphysematous pyelonephritis: A life threatening complication

Sigdel, B; Shrestha, Samir; Maskey, Pukar

doi:10.1016/j.ijscr.2021.106405

Cited by 3 publications

(5 citation statements)

References 14 publications

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“…However, if medical treatment fails, surgical interventions should be actively considered to resolve the abscess [3,4] . A recent report described the case of a patient with a forgotten stent complicated by emphysematous pyelonephritis and septic shock sequelae despite receiving appropriate antibiotic therapy and percutaneous drainage who ultimately underwent nephrectomy [5] . Our patient presented with fever and abdominal pain and showed urosepsis with acute obstructive pyelonephritis.…”

Section: Discussionmentioning

confidence: 86%

“…[ 3 , 4 ] A recent report described the case of a patient with a forgotten stent complicated by emphysematous pyelonephritis and septic shock sequelae despite receiving appropriate antibiotic therapy and percutaneous drainage who ultimately underwent nephrectomy. [ 5 ] Our patient presented with fever and abdominal pain and showed urosepsis with acute obstructive pyelonephritis. Upon arrival at the ED, she was immediately given IV administration of broad-spectrum antibiotics, fluid therapy, and PCD.…”

Section: Discussionmentioning

confidence: 94%

“…Structural anomalies of the urinary tract include staghorn calculi, neurogenic bladder, severe vesicoureteral reflux, obstructive uropathy, papillary necrosis, renal cysts, and polycystic kidney disease [3] . Cases of long-term neglected DJSs complicated by severe emphysematous UTI are extremely rare [5] . Herein, we report a case of emphysematous perinephric abscess in a patient with a DJS forgotten for 10 years after stent placement for decompression of an upper ureteral obstruction.…”

Section: Introductionmentioning

confidence: 96%

“…[ 3 ] Cases of long-term neglected DJSs complicated by severe emphysematous UTI are extremely rare. [ 5 ] Herein, we report a case of emphysematous perinephric abscess in a patient with a DJS forgotten for 10 years after stent placement for decompression of an upper ureteral obstruction. We also review the relevant literature.…”

Section: Introductionmentioning

confidence: 99%

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A forgotten double-J ureteral stent resulting in an emphysematous perinephric abscess

2022

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Rationale: Double-J stents (DJSs) are urologic devices widely used for urinary tract obstruction treatment. Perinephric abscess is a condition with purulent accumulation resulting from urinary tract infection retained between the renal capsule and Gerota's fascia. Emphysematous urinary tract infection in patients with a forgotten DJS is extremely rare. Herein, we report a case of emphysematous perinephric abscess as a complication in a 56-year-old non-diabetic woman who neglected a 10-year-old DJS placed for obstructive uropathy treatment. Patient concerns: The patient presented with fever and abdominal pain that persisted for 4 days. Laboratory examinations showed leukocytosis, hypoalbuminemia (2.3 g/dL), and elevated C-reactive protein level (305.5 mg/L) with no azotemia. Diagnosis: Abdominal computed tomography scan revealed a DJS with encrustation and multiple stones in the right kidney as well as a perinephric abscess with gas formation. Interventions: Intravenous administration of piperacillin/tazobactam was initiated immediately and percutaneous catheter drainage was performed. Extended-spectrum beta-lactamase-producing Escherichia coli was identified on abscess culture and antibiotics were switched to meropenem, resulting in gradual improvement of the inflammatory lesion. The patient was referred to the urology department for retained DJS removal and vesicolitholapaxy. A piece of fractured stent was removed via open ureterolithotomy. Outcomes: Since discharge on hospital day 42, she has been under regular follow-up, and the surgical wound has been healing with no significant sequelae. Lessons: Prompt medical therapy for inflammation and thorough urologic correction of the stent-induced structural deformities are crucial in long-term neglected DJS and resulting emphysematous perinephric abscess. Patients who undergo DJS placement should be systematically followed up to prevent potential neglect of device management.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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A forgotten double-J ureteral stent resulting in an emphysematous perinephric abscess

2022

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“…The indications for insertion of double J ureteric stent into urinary tract has expanded significantly during the last few decade (Tailly & Denstedt , 2016). Double J ureteric stent is inserted routinely to relieve or prevent ureter obstruction in patients with ureteral obstruction due to obstructing ureteral stone, ureter stricture, ureteral fistula, ureteral reconstruction, congenital anomalies as obstruction of uretero-pelvic junction, retroperitoneal fibrosis or tumor, or that developing following endoscopic or open ureter surgery (Sigdel et al, 2021). Placement of double J ureteric stent is not free of side effects and complications.…”

Section: Introductionmentioning

confidence: 99%

Double J Ureteric Stent: Effect of Developing and Implementing Nursing Educational Program on Patients Outcomes

Abdelmowla

Abdelmowla²,

Shahat³

et al. 2022

Assiut Scientific Nursing Journal

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Background: Double J ureteric stent commonly inserted for stone management. However, stent-related side effects still a major issue. Aim: The study aimed to evaluate the effect of developing and implementing nursing educational program on outcomes of patients with double J ureteric stent. Patients and methods: Research design: Quasi experimental research design. Sample and setting: A sample of "60" adult patients undergoing double J ureteric stent insertion, their ages from "18 -65" years. Patients assigned into 2 groups, each group "30" patients. Odd number = control group while even number = study group. Nursing educational program (brochure) introduced to patients of study group by researchers while patients of control group was received routine hospital instructions. Tools: Assessment sheet and King's health questionnaire. Results: Urinary tract infection demonstrated statistically significant difference between the two groups. It occurred in 93.3% of control group patients versus 46.7% of study group (p < 0.001). Patients' responses to King's health questionnaire conveyed significant difference in quality of life between the two groups (p < 0.001). Conclusion: Patients education reduce double J ureteric stent relatedsymptoms and significantly reduce complications and improve quality of life. Recommendation: Nursing educational program (brochure) should utilized in urology hospitals as teaching guide for patients with double J ureteric stent.

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Infecções Enfisematosas Abdominais- Revisão Pictórica

Mallet,

Machado,

Pinto

et al. 2024

Rev. Foco

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Infecções enfisematosas do abdome e da pelve representam condições incomuns, mas potencialmente fatais que requerem reconhecimento precoce. Podem se apresentar de diversas maneiras e na ausência de um diagnóstico precoce tendem a progredir para sepse e óbito. A tomografia é altamente sensível e específica tanto para detecção quanto para a avaliação da extensão e das complicações dessas condições. Diante disso, observamos a necessidade em demonstrar as principais características tomográficas de algumas dessas condições, como parte de um processo de estudos dos médicos residentes do setor de Radiologia e Diagnóstico por Imagem do Hospital Regional de Taguatinga. Para isso foram utilizados três casos de infecções abdominais enfisematosas, incluindo colecistite, pielonefrite e cistite agudas, atendidos no nosso hospital, com uma breve revisão dos aspectos clínicos, epidemiológicos e enfatizamos uma revisão dos aspectos tomográficos de cada condição. Por fim, o objetivo do trabalho é fazer com que o médico residente seja capaz de reconhecer as particularidades clínicas de cada condição e seus aspectos tomográficos.

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Forgotten DJ stent presenting with emphysematous pyelonephritis: A life threatening complication

Cited by 3 publications

References 14 publications

A forgotten double-J ureteral stent resulting in an emphysematous perinephric abscess

A forgotten double-J ureteral stent resulting in an emphysematous perinephric abscess

Double J Ureteric Stent: Effect of Developing and Implementing Nursing Educational Program on Patients Outcomes

Infecções Enfisematosas Abdominais- Revisão Pictórica

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