RESUMO
Emphysematous pyelonephritis (EP) is an uncommon condition involving acute severe necrotising infection in the renal parenchyma, perinephric space and collecting system, with a mortality rate of up to 13%. A 62-year-old male with poorly controlled diabetes mellitus presented with severe epigastric pain and shortness of breath for three days. A computed tomography scan revealed class 3B EP, which failed medical therapy and percutaneous drainage. He underwent a nephrectomy and achieved an excellent clinical recovery. Septic shock and uncontrolled diabetes mellitus are two risk factors that lead to a poorer prognosis. Class 3B EP with failed medical therapy and percutaneous drainage would benefit from nephrectomy.
RESUMO
Suprapubic catheterization (SPC) is a temporary measure to relieve acute urinary retention (AUR). Despite being effective, it can lead to complications such as colon perforation, haematuria, and bladder wall spasm. We present a 52-year-old lady with cystofix for underlying urethral stricture presented with AUR. A new SPC was inserted to drain the urine. However, the SPC had looped and entangled with her cystofix, and laparoscopic removal of cystofix and insertion of a new SPC was done. In conclusion, trapped cystofix to the SPC tube is a potential complication during SPC insertion that can be avoided with appropriate care.
