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Xanthogranulomatous pyelonephritis

Case contributed by Bruno Di Muzio
Diagnosis probable

Presentation

Diabetic patient presenting with left flank pain and fever.

Patient Data

Age: 65 years
Gender: Male

CT Abdomen and pelvis

ct

Large staghorn calculi in the left kidney collecting system. Renal calyces are dilated giving a multiloculated appearance. There is also a retroperitoneal collection that extends along the left iliac and psoas muscle.

Diagram

Large staghorn calculi in the left kidney collecting system. Renal calyces are dilated giving a multloculated appearance. 

Case Discussion

Xanthogranulomatous pyelonephritis is a chronic destructive granulomatous process of renal parenchyma in association with long-term urinary tract obstruction and infection.

Clinical presentation includes flank or abdominal pain, lower urinary tract symptoms, fever, palpable mass, hematuria and weight loss.

This case shows a xanthogranulomatous pyelonephritis associated with staghorn calculus and complicated with extensive retroperitoneal abscess.

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