最初診斷為中醫針灸引起的腎周圍膿瘍---病例報告
曾博鴻、陳柏華
彰化基督教醫院 外科部 泌尿科
Initially diagnosed of lumbar acupuncture related perinephric abscess - a Case Report
Po-Hung Tseng, Pao-Hwa Chen
Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
Introduction
Perinephric abscess results from perirenal fat necrosis. A perinephric abscess is usually a results of urological infection. Perinephric abscesses may arise from non-urological contiguous infections which may originate from trauma or an extension of infection from other body organs such as liver, cervix, pancreas, gallbladder, appendix, Crohn’s disease, or vertebral osteomyelitis. A perinephric abscess is more diffuse and affects the renal capsule and Gerota’s fascia. These abscesses can extend from the Gerota’s fascia into the psoas and transversalis muscles as well as peritoneal cavity and the pelvis.
If not properly treated, perinephric abscess results in significant morbidity and mortality. Percutaneous tube-directed drainage and antibiotic therapy are often the cornerstone of treatment. In severe uncontrolled infection, surgical debridement and nephrectomy are necessary. Local and distal complications from inflammation of adjacent structures, especially intraperitoneal spread, are rare
Case report
Conclusion
Lumbar acupuncture is a possible cause of unknown soft tissue infection, including perinephric abscess. Compared to conservative treatments, early intervention treatment is suggested to manage perinephric abscess.