Abstract
Report and discuss a case of emphysematous pyelonephritis in a renal allograft, emphasizing the ultrasound findings and correlated the computed tomography and surgical/pathological aspects. Male, 22 years, with terminal chronic kidney disease for polycystic kidney disease in early postoperative renal transplant, the patient developed pain in the right iliac fossa. Ultrasonography detected hypoechoic area suggestive of ischemia in the upper pole of the graft, which evolved into hypoechoic collection/heterogeneous, with gas in between. The association with tomographic findings, surgical (nephrectomy) and histopathology allowed close diagnosis. Emphysematous pyelonephritis in renal allograft. Severe condition inflammatory/infectious affecting renal grafts in situations of hypoxia, emphysematous pyelonephritis is a rare entity, with 14 cases described in the literature. Some authors classify it into two types: 1 - absence of fluid collections; 2 - fluid collection renal/perirenal, this being the patient in question. Escherichia coli is etiologic agent in over 50% of urocultures. Imaging tests are essential to diagnosis and associated conditions such as obstructive uropathy and nefrolitíases also are well evaluated by ultrasound. This method also enables guided percutaneous drainage, which associated with antibiotic therapy, has shown the best therapeutic option for these patients, previously widely treated with graft nephrectomy.
Published Version
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