癌末病人之產氣性腎盂腎癌的治療選擇─病例報告
盧誌明
佛教慈濟醫療財團法人大林慈濟醫院 泌尿科
Optional treatmnets for a terminal-stage patient with emphysematous pyelonephritis - a case report
Chih-Ming Lu
Department of Urology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
Case presentation: We report that an 83-year-old Taiwanese female with fever up to 38.5 C and conscious alternation. She has a history of diabetic mellitus, chronic kidney disease, thoracic aorta aneurysm S/P TEVAR four years ago, suspected right breast cancer without tissue proof with axillary lymph nodes involvement, and lung metastasis. A computed tomography showed left urolithiasis with hydroureteronephrosis and emphysematous pyelonephritis (EPN). Right breast cancer was suspected, however, family wished conservative treatment. She underwent percutaneous nephrostomy for drainage (PCND). The images and data will be presented.
Conclusion: PCND is helpful in accelerating resolution of the infection and minimizing the mortality and morbidity of the infection. Nephrectomy seems to play no role for a terminal patient with EPN.