PERCUTANEOUS DRAINAGE AS AN ALTERNATIVE OF SURGICAL MANAGEMENT IN PARARENAL ABSCESS: A CASE REPORT

Abstract

Objective: This case report will discuss the experience of using percutaneous drainage as an alternative of open surgery in pararenal abscess therapy. Case(s) Presentation: 61 years old woman complained of left flank pain 6 months before with septic condition. Physical examination revealed tenderness and mass in the left flank region with leukocytosis. Abdominal Computed Tomography (CT) Scan results showed a left lower pole pararenal abscess, severe hydropyonephrosis and ureteropelvic junction stones. Percutaneous abscess drainage and percutaneous nephrostomy was performed with an 18Fr troicart using ultrasound guidance. Discussion: The pus culture showed Escherichia coli bacteria. After three days of operation and intravenous antibiotics, the patient experienced clinical improvement. Outpatient follow-up showed decreased drain production from percutaneous abscess drainage and clear yellow liquid production from percutaneous. Percutaneous nephrolithotomy was performed for the management of stone evacuation. After going through the whole procedure, there is clinical improvement of patient. Conclusion: Percutaneous drainage is an alternative option in the management of perirenal abscesses. Compared to open surgical drainage, the percutaneous technique provides a minimally invasive process, shorter length of stay and more effective costs. This procedure has also shown good clinical improvement in patients. Keywords: Minimal invasive, pararenal abscess, percutaneous drainage.