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PERINEPHRIC
ABSCESS
Dr. P SANDEEP
PERINEPHRIC SPACE
PERINEPHRIC SPACE
Extension:
 Superior - open to bare area of liver and left
hemidiaphragm.
 Medial - closed medially
 ...
PERINEPHRIC SPACE
Contents:
•

•
•
•
•

Kidney, proximal collecting system, adrenal
gland,
Fat
Renal vasculature and perir...
A perinephric abscess may result due to
 Rupture of a renal abscess
 Directly from acute pyelonephritis.
 Any inflammat...
Extension of infection
Perinephric
Space

Posterior
Perirenal
Space
Laterally

Lateral
extraperiton
eal space
Lateral
abdo...
Radiographic features
Ultrasound:
 First imaging investigation
 Collection is usually hypo-echoic or of mixed
echogenici...
CT:
To define precisely the boundaries of the process &
its extension
 Areas of soft-tissue or fluid attenuation within
t...
CASE 1
CASE 2
IVU
Only indirect evidence such as
 Loss of the psoas shadow
 Poorly seen renal outline
 Reduced or absent renal functi...
Treatment




treated with imaged guided percutaneous
drainage. ultrasound-guided percutaneous
abscess drainage or CT gu...
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
Perinephric abscess imaging
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Perinephric abscess imaging

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Perinephric abscess imaging

  1. 1. PERINEPHRIC ABSCESS Dr. P SANDEEP
  2. 2. PERINEPHRIC SPACE
  3. 3. PERINEPHRIC SPACE Extension:  Superior - open to bare area of liver and left hemidiaphragm.  Medial - closed medially  Lateral - ARF, PRF fuse to form lateral conal fascia  Inferior - ARF & PRF converge blend about 8 cm below kidney .
  4. 4. PERINEPHRIC SPACE Contents: • • • • • Kidney, proximal collecting system, adrenal gland, Fat Renal vasculature and perirenal vessels Lymphatics Bridging septa
  5. 5. A perinephric abscess may result due to  Rupture of a renal abscess  Directly from acute pyelonephritis.  Any inflammatory process outside the Gerota's fascia
  6. 6. Extension of infection Perinephric Space Posterior Perirenal Space Laterally Lateral extraperiton eal space Lateral abdominal wall Medially Posteriorly Transversali s fascia psoas and quadratus Iumborum muscles Inferiorly along the psoas and then iliacus muscles into Pelvis Contralateral Perinephric Space
  7. 7. Radiographic features Ultrasound:  First imaging investigation  Collection is usually hypo-echoic or of mixed echogenicity depending on the content.  Septations and debris may be seen.  Gas may be noted within the abscess.
  8. 8. CT: To define precisely the boundaries of the process & its extension  Areas of soft-tissue or fluid attenuation within the perirenal space.  Chronic perinephric abscess may demonstrate an enhancing rim  It may extend to involve psoas muscle and upto pelvis.  Gas may be present within the abscess.
  9. 9. CASE 1
  10. 10. CASE 2
  11. 11. IVU Only indirect evidence such as  Loss of the psoas shadow  Poorly seen renal outline  Reduced or absent renal function manifested by failure to excrete or concentrate contrast.
  12. 12. Treatment   treated with imaged guided percutaneous drainage. ultrasound-guided percutaneous abscess drainage or CT guided. Only those with unsuccessful or inadequate treatment with percutaneous drainage and antibiotics tend to require surgery.

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