Akut kolesistit akut pyelonefritin bir komplikasyonu olabilir mi?
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Tarih
2009
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Üriner sistem enfeksiyonları toplumda en sık görülen enfeksiyonlardandır. Akut pyelonefrit bir üst üriner sistem enfeksiyonudur. Akut pyelonefrit (APN) yan ağrısı veya hassasiyeti veya her ikiside, ateş, idrar yaparken yanma-sızı, idrar kaçırma ve sık idrara çıkma şikâyetleri ile karakterize bir hastalıktır. Bu semptomlar enfeksiyon olmadan da bulunabilir (Ör: Renal enfakt, renal kalkül). En sık etken Escherichia coli’dir. Akut pyelonefrit geçiren hastalarda; renal abse, perirenal abse, karın içi abseler ve sepsis gibi komplikasyonlar gelişebilir (1). Akut kolesistit (AK); safra kesesi iltihabıdır. En sık nedeni safra yolları tıkanıklığıdır. Hastalar sıklıkla sağ üst kadran ağrısıyla başvururlar fakat bazı hastalarda lokalize bulgular bulunmayabilir. Hastalarda ateş, taşikardi sık görülen bulgulardandır. AK tanısı için ilk olarak ve en sık yapılması gereken görüntüleme metodu ultrasonografidir (US). Komplikasyondan şüphelenilen durumlarda bilgisayarlı tomografi (BT) çekilebilir (2).
Urinary tract infections are one of the most common infections in outpatient. Acute pyelonephritis is an upper urinary tract infection. Infections of the biliary tract are most often associated with obstruction to the flow of bile. Twenty-four years old female patient admitted to emergency clinic with complaints of fever, chill, shivering, myalgia, arthralgia, nausea, vomitting and right sided abdominal pain. In her past medical history, there was no disease other than nephrolithiasis. In her vital signs, body temperature was 39.8°C. In physical examination, there were pain at deep palpation of right upper quadrant of abdomen and right costovertebral angle. Also, there was Murphy sign. Other system examination was normal. At the admission time, in laboratory examination; white blood count was 15.270/mm3 with 90 % of neutrophile. Microscobic examination of urine showed puyuria. Abdominal ultrasound revealed edema and thickening of fundus (5.3 mm) of gall bladder and dilatation of right proximal urether and mucosal edema of right renal pelvis and proximal urether. Abdominal computerize tomography showed 2x2.5x5 cm hypodense lesion with irregular border at the cortical region of the middle zone of right kidney and hypodense effussion around the gall bladder. With the diagnosis of pyelonephritis, renal abscess and acute cholecystitis treatment of ceftriaxone 2x1 gr/day and ornidasole 2x500 mg/day was given for 3 weeks. There were no other complaints in 6 months of follow.
Urinary tract infections are one of the most common infections in outpatient. Acute pyelonephritis is an upper urinary tract infection. Infections of the biliary tract are most often associated with obstruction to the flow of bile. Twenty-four years old female patient admitted to emergency clinic with complaints of fever, chill, shivering, myalgia, arthralgia, nausea, vomitting and right sided abdominal pain. In her past medical history, there was no disease other than nephrolithiasis. In her vital signs, body temperature was 39.8°C. In physical examination, there were pain at deep palpation of right upper quadrant of abdomen and right costovertebral angle. Also, there was Murphy sign. Other system examination was normal. At the admission time, in laboratory examination; white blood count was 15.270/mm3 with 90 % of neutrophile. Microscobic examination of urine showed puyuria. Abdominal ultrasound revealed edema and thickening of fundus (5.3 mm) of gall bladder and dilatation of right proximal urether and mucosal edema of right renal pelvis and proximal urether. Abdominal computerize tomography showed 2x2.5x5 cm hypodense lesion with irregular border at the cortical region of the middle zone of right kidney and hypodense effussion around the gall bladder. With the diagnosis of pyelonephritis, renal abscess and acute cholecystitis treatment of ceftriaxone 2x1 gr/day and ornidasole 2x500 mg/day was given for 3 weeks. There were no other complaints in 6 months of follow.
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24
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