기종성 농흉 및 기종격동을 동반한 기종성 신우신염 1예
A case of emphysematous empyema and pneumomediastinum associated with emphysematous pyelonephritis
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초록
저자들은 기종성 신우신염이 복강 및 후복강을 통해 종격동과 흉막까지 광범위하게 퍼진 사례를 체험하였기에 이를 보고하는 바이다.
Abstract
Emphysematous pyelonephritis (EPN) is a necrotizing infection characterized by the accumulation of gas in the renal parenchyma and surrounding tissues. Although there have been a few cases of EPN accompanied by either pneumoperitoneum or pneumomediastinum, this case should be considered important due to the marked extent of the emphysematous empyema. The patient did not know of her diabetes until admission. Her HbA1c was 15.3% on admission. Her symptoms included dyspnea, fever, and left-side flank pain. Hypotension and tachycardia were strongly suggestive of sepsis. The simple x-ray and abdominal and chest computed tomography (CT) findings confirmed the diagnosis of EPN extending to the thoracic cavity. A combination of antibiotics and percutaneous drainage was performed. After several weeks, the patient underwent a nephrectomy. Despite these attempts, the patient died due to postoperative infection combined with hospital-acquired pneumonia.
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