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Treatment of xanthogranulomatous pyelonephritis involves antibiotics as well as surgery. Removal of the kidney is the best surgical treatment in the overwhelming majority of cases, although polar resection (partial nephrectomy) has been effective for some people with localized disease.
It is generally not recommended to perform routine radiographic imaging on patients who have simple urinary tract infections. When patients do not improve quickly with appropriate antibiotics , however, appropriate radiographic studies help diagnose pyonephrosis, emphysematous pyelonephritis, and renal and/or perirenal abscesses.
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
In terms of cause, almost any condition that involves ischemia can lead to renal papillary necrosis. A mnemonic for the causes of renal papillary necrosis is POSTCARDS: pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, cirrhosis of the liver, analgesia/alcohol use disorder, renal vein thrombosis, diabetes mellitus, and systemic vasculitis. [3]
Abdominal pain, nausea, vomiting, and fever. [1] Complications: Acute kidney injury and chronic kidney disease. [1] Causes: Cardioembolic disease, renal artery injury, and hypercoagulable state. [1] Diagnostic method: Hematuria, elevated lactate dehydrogenase, CT scan. [1] Differential diagnosis: Renal colic and acute pyelonephritis. [1 ...
CVA tenderness is often present in acute pyelonephritis. [ 5 ] [ 4 ] [ 6 ] [ 7 ] CVA tenderness may be present in patients who have a kidney stone , [ 8 ] [ 7 ] a stone in the ureter , [ 8 ] a ureteropelvic junction obstruction, [ 8 ] a kidney abscess , [ 8 ] a urinary tract infection , [ 9 ] and vesicoureteral reflux . [ 10 ]
Lloyd's sign indicates the presence of renal calculus or pyelonephritis when pain is elicited by deep percussion in the back between the 12th rib and the spine. [1] It is closely related to costovertebral angle tenderness, as the area of percussion is the same. However, Lloyd's sign is specifically defined as positive costovertebral angle ...
Abdominal imaging is associated with many potential uses for the different phases of contrast CT.The majority of abdominal and pelvic CT's can be performed using a single-phase, but the evaluation of some tumor types (hepatic/pancreatic/renal), the urinary collecting system, and trauma patients among others, may be best performed with multiple phases.