Emphysematous pyelonephritis: A 15-year experience with 20 cases

194 Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up

“…Diabetes mellitus was the most frequently reported predisposing factor for developing EPN, as it constituted 80-100% of patients [5,14,15]. Of the present patients, 77% were diabetic, and the second predisposing factor was urolithiasis; the same was reported by Kapoor et al [12].…”

“…Emergency nephrectomy was considered by some authors as the surgical treatment of choice and a life-saving procedure for treating EPN [5,6]. This taboo was also rejected in recent years and a new treatment strategy of kidney preservation emerged [8][9][10][11].…”

“…This taboo was also rejected in recent years and a new treatment strategy of kidney preservation emerged [8][9][10][11]. The reasons for this change were the high mortality rates of emergency nephrectomy (17.6-40%) [5,6] and advances in image-guided procedures for drainage of the gas and infected fluids, using PCDs [9,10]. Chen et al [8], in their experience with 25 patients, suggested that percutaneous drainage is safe and effective for EPN, and that can result in cure.…”

“…Emergency nephrectomy after medical control of septicaemia and diabetes was reported [5,6]. The availability of effective antibiotics and advances in image-guided procedures resulted in the use of less aggressive surgical approaches such as percutaneous drainage [7][8][9].…”

Pielonefritis enfisematosa: Reporte de dos casos y revisión de la literatura.

“…La enfermedad es poco frecuente pero con elevada mortalidad debido a complicación séptica. Por lo general se presenta en mujeres adultas y en diabéticos (1)(2)(3)(4). Usualmente afecta a un riñón; la pielonefritis enfisematosa bilateral es rara (5).…”