How does kidney have abscess to want to do inside?

summary

Renal abscess refers to a part of the body purulent infection focus or bacteria blood to the renal cortex, causing local or total renal tissue infection. Renal abscess is suppurative infection of renal cortex. It is a serious infection caused by Staphylococcus entering renal cortex through blood circulation. In the early stage, it is edema, accompanied by a number of small abscesses. Small abscesses can form infectious masses. In severe cases, typical renal abscess is formed when necrosis and liquefaction are obvious. Most of them are caused by hematogenous infection, and can also be caused by retrograde urinary tract infection. How does that kidney have abscess to want to do inside?

How does kidney have abscess to want to do inside?

Several small abscesses were formed in the renal cortex, which could also invade the renal medulla. About 50% of renal abscess infection spread to the renal capsule and invaded into the perirenal space, resulting in the formation of perirenal abscess. Clinically, it is characterized by sudden onset, fever, renal percussion pain and muscle tension, increased white blood cells in urine, and growth of pathogenic bacteria in urine culture.

CT findings: the manifestations of renal abscess vary with different stages of the disease. In the early stage of inflammation, the abscess was not localized, showing a slightly low-density mass in the renal parenchyma, and mild irregular enhancement could be seen in contrast-enhanced examination; In the mature stage of the abscess, it showed round homogeneous low-density focus with clear or fuzzy edge, surrounded by slightly high-density rings with different thickness. The enhanced examination showed obvious ring enhancement, representing the abscess wall, while the central low-density area had no enhancement, which was the abscess cavity, and low-density gas shadow could be seen in some of the abscess cavities. When the infection of renal abscess spread to the perirenal space, the density of perirenal fat increased. When combined with perirenal and pararenal abscess, the perirenal and pararenal fat space disappeared, replaced by a mixed density mass, with small bubbles in it. Enhanced examination showed regular or irregular single or multiple circular enhancement.

In the ultrasound-guided puncture treatment of renal abscess, the key to successful puncture is accurate ultrasound positioning. Because of its unique acoustic beam thickness artifact, ultrasound guidance is easy to show the puncture needle close to the outside of the abscess as entering the abscess, so the choice of puncture path is very important. First of all, the appropriate position and puncture site should be selected according to the position of the abscess cavity in the kidney and the distance from the epidermis, including puncture point, angle and depth. Secondly, we should avoid the large blood vessels in the kidney and the liver, spleen, lung, intestine, etc. In the process of aspiration, the pus should be washed as far as possible, and then the drug should be injected. Before the operation, the patients were told the puncture steps to eliminate the tension of the patients, and the patients were asked to hold their breath to prevent the deviation caused by breathing during the puncture.

matters needing attention

If the renal abscess does not liquefy in the early stage to form an abscess or when there are many dead objects in the abscess, the pus is viscous, and there is a strong light mass on the sonogram, which is very similar to the renal parenchymal space occupying. It is easy to be misdiagnosed as renal cancer or renal tuberculosis. Dynamic observation and puncture are helpful for differential diagnosis, and can improve the diagnostic ability of abscess. According to relevant data reports, the diagnosis rate of ultrasound-guided percutaneous puncture treatment for renal abscess can reach 100%. The pus obtained by puncture can be examined by routine and cytology, biochemistry, bacteriology and drug sensitivity test, which is helpful to the etiological diagnosis of abscess and is of great help to clinical medication.