Spontaneous intraperitoneal rupture of pyonephrosis in a patient with unknown kidney carcinosarcoma: a case report

Quaresima, Silvia; Manzelli, Antonio; Ricciardi, Edoardo; Petrou, Athanasios; Brennan, Nicholas; Mauriello, Alessandro; Rossi, Piero

doi:10.1186/1477-7819-9-39

Cited by 12 publications

(5 citation statements)

References 13 publications

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“…In the literature, there are reports of cases who sustained spontaneous intraperitoneal rupture and life-threatening hemorrhage due to the aggressive nature of carcinosarcomas (14). This type of biphasic tumor is associated with poor prognosis and such tumors are devoid of natural barriers due to the mesenchymal tissue arising from the sarcomatoid component, whereas the tumors typically carry a pseudocapsule.…”

Section: Discussionmentioning

confidence: 99%

Multiple carcinosarcomas of the kidney: A case report and review of the literature

Öztürk

2014

Molecular and Clinical Oncology

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Abstract. Carcinosarcomas are biphasic tumors comprising epithelial and mesenchymal components. Primary carcinosarcoma of the kidney is extremely uncommon and accounts for <1% of all malignant renal tumors. Primary carcinosarcoma of the kidney generally occurs after the age of 60 and the majority of the patients are men. This is the case report of a 56-year-old male patient who presented with left flank pain. Ultrasonography and computed tomography (CT) revealed ureterohydronephrosis and a left distal ureteral stone (25 mm). Renal scan with diethylenetriamine pentaacetate and dimercaptosuccinic acid revealed a non-functional kidney and a left nephroureterectomy was performed. The pathological examination of the surgical specimen revealed high

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Section: Discussionmentioning

confidence: 99%

Multiple carcinosarcomas of the kidney: A case report and review of the literature

Öztürk

2014

Molecular and Clinical Oncology

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“…Generalized peritonitis can result from a rupture of the pyonephrotic kidney. Intraperitoneal and retroperitoneal spontaneous rupture has been quite frequently reported, making it possibly much more common than originally thought [ 33 , 37 , 38 , 39 , 40 ].…”

Section: Ctmentioning

confidence: 99%

Pyonephrosis Ultrasound and Computed Tomography Features: A Pictorial Review

Tamburrini¹,

Lugarà²,

Iannuzzi³

et al. 2021

Diagnostics

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Urinary tract infections (UTIs) are the most frequent community-acquired and healthcare-associated bacterial infections. UTIs are heterogeneous and range from rather benign, uncomplicated infections to complicated UTIs (cUTIs), pyelonephritis and severe urosepsis, depending mostly on the host response. Ultrasound and computed tomography represent the imaging processes of choice in the diagnosis and staging of the pathology in emergency settings. The aim of this study is to describe the common ultrasound (US) and computed tomography (CT) features of pyonephrosis. US can make the diagnosis, demonstrating echogenic debris, fluid/fluid levels, and air in the collecting system. Although the diagnosis appears to be easily made with US, CT is necessary in non-diagnostic US examinations to confirm the diagnosis, to demonstrate the cause and moreover to stage the pathology, defining extrarenal complications. In emergency settings, US and CT are differently used in the diagnosis and staging of pyonephrosis.

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“…More commonly, kidney ruptures occur at the site of the renal parenchyma over the renal pelvis [8]. Rarely, forniceal rupture occurs in patients with pyelonephritis or pyonephrosis, especially if there is an obstruction [9].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of pyonephrosis presenting as anterior abdominal wall abscess: a rare case report

et al. 2021

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Background A pyonephrosis caused by an obstructing calculus is typically accompanied by fever, loin pain, and other signs of urinary tract infection. Occasionally, severe thinning of the renal parenchyma in pyonephrosis allows direct forniceal rupture into the retroperitoneum and very rarely into the anterior abdominal wall, misconstruing it as an isolated abdominal wall abscess. Case presentation Diabetes-related 55-year-old diabetic male presented with abscess in his periumbilical region extending into right lumbar region. He did not exhibit any urinary symptoms, and contrast enhanced computed tomography [CECT] abdominal and pelvic examinations revealed right pelvic calculus with pyonephrosis. There is a 7.5 mm defect in the lower pole of the right kidney with 171 cc of collection adjacent to the kidney communicating with 150 cc of superficial abdominal wall collection through a 15 mm defect. Incision and drainage of abdominal and retroperitoneal abscesses were done at first. Right DJ stenting was performed. Right lateral decubitus was placed for dependent drainage. Resolution of residual collections was confirmed by subsequent ultrasonography KUB, and drain was then removed. Right DJ stenting done, and patient was discharged. Two months later, DTPA scan done and revealed GFR of 30 ml/min of right kidney. Patient underwent right percutaneous nephrolithotomy. Conclusion The sudden rupture of pyonephrosis is a rare event. Even rarer is the presentation of pyonephrosis as an abscess on the anterior abdominal wall. The correct diagnosis and search for the source of the abscess must be undertaken before intervention. An aggressive and prompt management is needed to prevent further complications from occurring. This case is being presented to add to the literature with regard to abnormal presentations of ruptured pyonephrosis and its management.

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Spontaneous intraperitoneal rupture of pyonephrosis in a patient with unknown kidney carcinosarcoma: a case report

Cited by 12 publications

References 13 publications

Multiple carcinosarcomas of the kidney: A case report and review of the literature

Multiple carcinosarcomas of the kidney: A case report and review of the literature

Pyonephrosis Ultrasound and Computed Tomography Features: A Pictorial Review

Spontaneous rupture of pyonephrosis presenting as anterior abdominal wall abscess: a rare case report

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