Pyonephrosis other imaging findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Harsh Vardhan Chawla, M.B.B.S.[2]

Overview

Other investigations that might be used to diagnose pyonephrosis are renal nuclear scanning and antegrade nephrostography. Renal nuclear scanning aids in determining the functionality of the involved kidney after the infection has resolved whereas antegrade nephrostography is used to determine the cause of the obstruction contributing to pyonephrosis for definitive treatment.

Other imaging findings

Other investigations that might be used to diagnose pyonephrosis are:

Renal nuclear scanning

Renal nuclear scanning aids in determining the functionality of the involved kidney after the infection has resolved.^[1]
Consequently, this diagnostic modality is not a part of the initial diagnostic workup of pyonephrosis.
Defects in the uptake of the radionuclide indicate irreversible damage to the renal cortex.^[2]
Nonfunctional kidney even after treatment of the underlying cause such as obstruction, demands nephrectomy to prevent recurrence of pyonephrosis.

Antegrade nephrostography

To determine the cause of the obstruction contributing to pyonephrosis for definitive treatment.
Invasive procedure
Deferred until the patient is hemodynamically stable, on antibiotic treatment, and 1-2 weeks past drainage of the pus and placement of nephrostomy tube.^[3]

References

↑ Chroustová D, Palyzová D, Urbanová I, Kolská M (2006). “Results of a five-year study of 99mTc DMSA renal scintigraphy in children and adolescents following acute pyelonephritis”. Nucl Med Rev Cent East Eur. 9 (1): 46–50. PMID 16791804.
↑ Alsowayan OS (2020). “A Rare Case of Pyonephrosis in an Infant Induced by Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae”. Saudi J Med Med Sci. 8 (2): 156–159. doi:10.4103/sjmms.sjmms_91_18. PMC 7305680 Check |pmc= value (help). PMID 32587499 Check |pmid= value (help).
↑ Andonian S, Okhunov Z, Shapiro EY, Smith AD, Okeke Z (2010). “Diagnostic utility and clinical value of postpercutaneous nephrolithotomy nephrostogram”. J Endourol. 24 (9): 1427–30. doi:10.1089/end.2010.0173. PMID 20677992.

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[pmid16791804-1] Chroustová D, Palyzová D, Urbanová I, Kolská M (2006). “Results of a five-year study of 99mTc DMSA renal scintigraphy in children and adolescents following acute pyelonephritis”. Nucl Med Rev Cent East Eur. 9 (1): 46–50. PMID 16791804.

[pmid32587499-2] Alsowayan OS (2020). “A Rare Case of Pyonephrosis in an Infant Induced by Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae”. Saudi J Med Med Sci. 8 (2): 156–159. doi:10.4103/sjmms.sjmms_91_18. PMC 7305680 Check |pmc= value (help). PMID 32587499 Check |pmid= value (help).

[pmid20677992-3] Andonian S, Okhunov Z, Shapiro EY, Smith AD, Okeke Z (2010). “Diagnostic utility and clinical value of postpercutaneous nephrolithotomy nephrostogram”. J Endourol. 24 (9): 1427–30. doi:10.1089/end.2010.0173. PMID 20677992.

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