The author found the sensitivity of 75% and specificity of 70% of computed tomography (CT) in detecting
perinephric fat infiltration in renal cell carcinoma patients.
In case the presence of pyelonephritis with obstructive uropathy, renal abscess,
perinephric abscess, emphysematous pyelonephritis, or emphysematous cystitis, bacteremia is seen very frequently and the infection may be fatal.
In our case, the serum renin level was normal, however, since needle aspiration of the left perirenal collection was not performed, we do not know the renin level in the
perinephric fluid.
Perinephric fluid collections include hematoma, seroma, lymphocele, urinoma, and abscesses.
No major complications were encountered although five minor complications occurred (pyonephrosis, n=1;
perinephric hematoma, n=2; retroperitoneal bleeding, n=1; postprocedural nausea, n=1).
One patient who had tested positive for HIV presented with a right
perinephric abscess tracking down through right psoas muscle, bladder distension, severe urethral stenosis and septicaemia and raised renal parameters.
The operation was technically difficult due to the
perinephric abscess and frozen abdomen, pursuant to her previous oncological treatment.
Omentalisation of
perinephric pseudocysts in a cat.
However, in a verbal read from the on-call radiologist, concern was communicated for right forniceal rupture given the constellation of radiologic findings of hydroureter combined with
perinephric and retroperitoneal fluid, highlighted in Figure 1.
Histopathology revealed a 5 cm, clear cell carcinoma, Fuhrman grade 2 with invasion of the
perinephric fat and renal vessels.
No gross invasion of the renal capsule or
perinephric fat was identified, and the adrenal glands were unremarkable (Figure 1).
His postoperative course was complicated by the development of a
perinephric hematoma, acute tubular necrosis, and urinary tract infection with extended-spectrum beta-lactamase producing Escherichia coli.