Drainage Renal Abscess

To drain a large abscess causing low grade to high temperatures. Percutaneous or open procedure for the drainage of abscess.

Patients presenting with low grade persistent fevers, even high fevers requiring admission to High Dependency Unit for septicemia.
Usually immune compromised patients: Diabetics, Corticosteroid users, Viral immune-deficiency states etc.
This condition requires urgent drainage.
The patients’ need to be resuscitated first by an emergency team with appropriate fluids and antibiotics and placed in an area where all systems can be supported (HDU).
As soon as the patient is stable, this abscess needs to be drained, either with open surgery or percutaneous drain placement.
If it is a large pyonephrosis with a non-functioning kidney, a nephrectomy should be considered.

Patients will receive a general anesthesia.
Appropriate resuscitation would have been started.
Prophylactic anti-biotics is given.
An indwelling catheter is placed.
The correct kidney is identified and marked while you are awake.
If it is a small abscess, an ultrasound guided needle is placed through your back or side into the fluid collection. A guidewire will be placed through the cannula and a drain fed in over the guidewire. All the pus will be drained.
If it is a large loculated abscess, an incision will be made over the area closest to the skin. The cavity will be opened, drained and rinsed, after which a drain will be placed.
If you have a non-functioning kidney associated with this, your kidney may be removed at the same time.
A drain is left post-operatively.

You will spend up to 7 or more nights in hospital.
You may be on life support depending on the degree of sepsis.
You will have intravenous fluids, antibiotics and circulatory supporting drugs being administered. Either a central venous line for monitoring, an arterial line and a peripheral infusion line.
You will have a catheter for that time.
A drain for 2-3 days.
Your drain will be removed with minimal drainage present.
You will a trial without the catheter as soon as you are back in the ward.
You will be discharged as soon as your renal function has stabilized, and you have opened your bowels.
Allow for 6 weeks for stabilization of symptoms.
A follow-up appointment will be scheduled for 6 weeks.
DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!

This a potentially dangerous condition, which could result in death. It requires urgent management!
May lose your kidney in serious cases.
May risk dialysis when in septic shock.
Wound Infection.
Prolonged stay in HDU.
Post-operative hernia formations especially associated in the elderly with atrophic abdominal muscles.
NB! Each person is unique and for this reason symptoms vary

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Wes Drainage renal abcess