Late and Rare Complications of Urolithiasis: Perinephric Abscess and Renal Replacement Lipomatosis

Abstract

Background: Perinephric abscess and renal replacement lipomatosis (RRL) as a late and rare complications of urolithiasis.Case presentation: We report the case of a 62-year-old Kazakh woman who suffered for a long period of time from back pain,weakness (has been treated with confirmed osteochondrodystrophy) and was not aware about her kidney stones. She hadnever had hematuria or renal colic and urgently was admitted in a serious condition with large palpable abdominal mass. Thediagnostic workup, differential diagnosis, surgical management, medical follow-up and a review of the literature presented.Persistent back pain and weakness for several years were caused by nephrolithiasis and its late and rare complications likeRRL. Only one of the acute complications of nephrolithiasis as perinephric abscess attracted the attention of urologists andmade it possible to set up the correct diagnosis. Surgical management of the hephrolithiasis complications (urgent drainage ofperinephric abscess and delayed nephrectomy [because nonfunctioning kidney with multiple stones as a nidus of infectionsand RRL] after stabilization of patient’s condition was performed.Conclusion: Occasionally urolithiasis may mimic signs of spine disease, so in patients with persistent back pain which did notrespond to conventional therapy of this pathology should be excluded the hephrolithiasis. Non-treated urolithiasis may lead toloss of the kidney function and development of life-threatening acute complications like perinephric abscess and later – renalreplacement lipomatosis.