PMC5943861_01
Chronic open wound.
medi-97-e9659-g001.jpg
PMC5943861_01_medi-97-e9659-g001.jpg
F1
The patient initially presented to the hospital with a chronic open wound and purulent discharge on his right back for 6 months (Fig. 1).
After incision and drainage, cutaneous fistula is shown.
medi-97-e9659-g002.jpg
PMC5943861_01_medi-97-e9659-g002.jpg
F2
Incision and drainage (Fig. 2) were initially performed and the pus was sent for culture, which revealed Pseudomonas aeruginosa.
Preoperative CT. XGP extend pararenal space is shown with "bear paw" sign.
medi-97-e9659-g003.jpg
PMC5943861_01_medi-97-e9659-g003.jpg
F3
A CT scan (Fig. 3) with intravenous and oral contrast revealed a right-sided renal obstructing stone and enlarged right kidney with multiple low-attenuation cytic lesions, showing "bear paw" like signs, and a perinephric fluid collection that communicated with the cutaneous fistula and right psoas muscle.
Macroscopic appearance of right kidney. Enlarged right kidney with renal obstructing stone.
medi-97-e9659-g004.jpg
PMC5943861_01_medi-97-e9659-g004.jpg
F4
The renal pelvis was filled with multiple deep brown-colored dystrophic calcification, greatly expanding the renal pelvis and atrophying the renal parenchyma (Fig. 4).