PMC6340375_01
Redness and swelling of the left abdominal and lumbar area.
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Clinical examination on arrival showed rising swelling and redness extending from left lumbar to left abdominal area (Fig. 1).
Sagittal section of CT of the abdomen showing large retroperitoneal and subcutaneous pus collection arising from the left kidney.
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The CT scan of the abdomen with intravenous contrast revealed hydronephrosis and multiple stones in the left renal pelvis, as well as fluid attenuation of ~30 HU-suggesting of pus within the left perirenal and pararenal area; the psoas muscle was also infiltrated and the collection extended toward the skin (Figs. 2 and 3).
Coronal section of CT of the abdomen showing large retroperitoneal collection around the left kidney infiltrating the ipsilateral psoas muscle.
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The CT scan of the abdomen with intravenous contrast revealed hydronephrosis and multiple stones in the left renal pelvis, as well as fluid attenuation of ~30 HU-suggesting of pus within the left perirenal and pararenal area; the psoas muscle was also infiltrated and the collection extended toward the skin (Figs. 2 and 3).
CT of the abdomen 4 days after surgical debridement, showing significant reduction of the collection with a Double-J stent in the left renal pelvis.
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A new CT scan was performed, which showed significant reduction of the perirenal accumulation, with remaining pus in the renal calyces (Fig. 4).