Presentation
Right loin pain and fever
Patient Data
There is a necrotic lesion at the right kidney lower pole anteriorly with thick septations, invading anterior renal capsule with perirenal extension and invasion of segment VI of the liver. It shows fluid density core and marginal enhancement. It is compressing the lower calyx with no pelvicalyceal extension. Renal and hepatic mild perifocal edema is noted. No solid component. No filling defect in the right renal vein. Enlarged portocaval and right renal hilar lymph nodes.
Case Discussion
The clinical context and radiological features are most consistent with renal abscess with anterior pararenal extension and hepatic extension forming abscess at segment VI. Treatment can be a course of antibiotics and image-guided percutaneous drainage.