A renal abscess, also called perinephritic abscess, is an accumulation of pus between renal tissue and the connective tissue sheath surrounding the kidney (Gerota fascia). A renal abscess can be caused by an inflammation of the kidney or by a tumorous event. In this case the kidney tissue affected by cancer cells decays and becomes infected.
Patients who are in intensive care, receive dialysis therapy for renal insufficiency, have a weakened immune system or heart valve disease have an increased risk of a staphylococcal kidney abscess. People who abuse intravenous drugs also have an increased risk of kidney abscesses. A kidney abscess is noticeable in addition to symptoms such as fever, chills and fatigue due to flank pain that can radiate to the abdomen or back.
Inflammation values such as CRP or procalcitonin are examined. In addition, the kidney values should be observed in order to detect a restriction of the kidney function at an early stage. The urine should also be examined for bacteria.
An ultrasound or CT examination can visualise the abscess. In addition to antibiotic therapy, it is important to remove the abscess. First of all, a drainage is inserted through the skin. If this is unsuccessful, surgical removal will be necessary.
If the abscess has burst
An abscess in the abdomen is an encapsulated collection of pus. The material contained in the abscess contains cells of the human immune system, dead cells and remains of dead tissue as well as a high concentration of bacteria. If the abscess bursts, the pathogens are distributed in the abdominal cavity and sometimes cause life-threatening inflammation of the peritoneum.
The peritoneum is a smooth layer that surrounds the organs within the peritoneal cavity. Peritonitis causes severe abdominal pain, a weakening of bowel activity and a strong tension of the abdominal wall muscles when touched. The patient’s general condition can deteriorate rapidly, and breathing and circulation can be increasingly impaired.
If peritonitis is not treated in time, there is a risk that bacteria will enter the bloodstream. The result is blood poisoning. If an abscess bursts in the abdominal cavity, an operation must be performed under general anaesthetic.
Through an incision in the abdominal wall, pus and secretions are sucked out, remains of the abscess cavity are detected and repaired. The abdominal cavity is rinsed several times, whereby the rinsing fluid is usually mixed with antibiotics or germicidal substances. Drainage tubes are placed and left in place for a few days to drain off any wound secretions that may have accumulated after the operation. The prognosis depends on the extent of the disease. The earlier treatment is initiated, the better the prognosis, so that the first signs of a ruptured abscess in the abdominal cavity require intensive medical treatment.