Subcapsular renal collection - causing a Page kidney

Case contributed by Dr Ian Bickle


39 year-old diabetic. Septic. Cause unidentified.

Patient Data

Age: 40 years
Gender: Male

Large BMI. Uncooperative patient. Ultrasound technically challenging. CT undertaken.

Multiple focal low attenuation areas in the right kidney, suggestive of a pyelonephritis and a subcapsular collection, with maximum depth of 3.5cm.

Poor venous access, resulted in a sub-optimal contrast enhanced scan - diagnostic discussion if subcapsular or perinephric collection.

Mass effect from the collection gives rise to an appearance of Page kidney. 

Given clinical status and after multi-disiplinary discussion, CT guided drainage performed.

Patient unable to lie prone.  Lateral position used for drainage.

Bone window allows needle, wire and drain to be easily visualized.

Seldinger technique used. 8F drain inserted using CT fluroscopy.

90mls blood stained pus aspirated on table and drain left in situ.

Case Discussion

Retroperitoneal collection

Patient with large body habitus

Poorly cooperative patient

Ideal candidate for CT guided drainage.

Related articles

Acute pyelonephritis

Page kidney

CT guided percutaneous drainage

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Case information

rID: 22292
Published: 25th Mar 2013
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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