MP29-19 NOVEL SCORING SYSTEM AND ADVANCED MANAGEMENT ALGORITHM FOR EMPHYSEMATOUS PYELONEPHRITIS

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease the Genitourinary Tract: Kidney & Bladder II (MP29)1 Sep 2021MP29-19 NOVEL SCORING SYSTEM AND ADVANCED MANAGEMENT ALGORITHM FOR EMPHYSEMATOUS PYELONEPHRITIS Rohit Ranjan, Ankur Mittal, Vikas Panwar, Navriya Shivcharan, Shanky Singh, and Arup Kumar Mandal RanjanRohit Ranjan More articles by this author , MittalAnkur Mittal PanwarVikas Panwar ShivcharanNavriya Shivcharan SinghShanky Singh MandalArup View All Author Informationhttps://doi.org/10.1097/JU.0000000000002026.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION OBJECTIVE: Emphysematous pyelonephritis (EPN) is an acute severe necrotizing infection which results in gas within pelvicalyceal system, renal parenchyma, or perinephric tissue. It has very high rate nephrectomy mortality up 40-50%. Early aggressive medical treatment diversion system may avoid nephrectomy. In study, we analysed characteristics patients with EPN respect their demography, clinical presentation, radiological image, microbiological findings, modality outcome. We also introduce scoring classify patient for internal external diversion. METHODS: retrospective study included 40 consecutive coming our tertiary care hospital diagnosed EPN, from June 2018 December 2020. Diversion was done, either (DJ stent) (percutaneous nephrostomy, PCN). RESULTS: Mean age 55.8 years 4.9 days mean duration illness. 90.6% were sepsis 46.9% shock. Most commonly isolated organism E. coli (68.8%) antibiogram Piperacillin Tazobactam (71.9%). 66.7% had higher grade (3 4). common cause stone (65.6%) followed diabetes (56.3%). DJS done 24 (60%) sufficient 17 (70.8%) 2 expired (8.3%). PCN 16 (40%) 14 (87.5%) (12.5%). So total 35 treated successfully just (internal external) circumvented. identified certain risk factors gave score (1-3) each, based on weightage prognosis, like- Age >45 years, Haemoglobin <9 gm/dL, S. Creatinine >3 mg/dL, Arterial Pressure <65 mm Hg, Presentation diagnosis >72 hours, High 4), Subcutaneous emphysema collection Complication other system. calculated all retrospectively 15 7 less, success 100% both, (15/15) (4/4); whereas 25 more than 7, 83.3% (10/12) 22.2% (2/9) DJS. CONCLUSIONS: With availability wide range antibiotics along timely intervention form effective curative 87.5% patients. If less then if its (PCN) should be preferred. Nephrectomy can considered only deteriorate do not improve conservative after Source Funding: Nil © 2021 American Urological Association Education Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e498-e498 Advertisement Copyright Permissions© Inc.MetricsAuthor Information Expand Loading ...