Obstructive Pyelonephritis in a Diabetic … Think Sloughed Papilla!

Main Article Content

Sarah Mason
Daniel W Good
Feras Al Jaafari

Keywords

obstructive, uropathy, tubular, necrosis, diabetes

Abstract

This case describes a patient presenting with AKI, loin pain, pyrexia and unilateral hydronephrosis secondary to obstructing sloughed papilla. It demonstrates the importance of considering alternative causes of radiolucent obstructive uropathy in patients with poorly controlled diabetes mellitus especially where there are risk factors for renal papillary necrosis. 

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References

1. Marchioni M, Primiceri G, Cindolo L, Hampton LJ, Grob MB, Guruli G, Schips L, Shariat SF, Autorino R.Impact of diagnostic ureteroscopy on intravesical recurrence in patients undergoing radical nephroureterectomy for upper tract urothelial cancer: a systematic review and meta-analysis. BJU Int 2017 Sep;120(3):313–19. doi: 10.1111/bju.13935. Epub 2017 Jul 19.
2. “Papillary Necrosis: Practice Essentials, History of the Procedure, Problem.” [Online]. Available: https://emedicine.medscape.com/article/439586-overview. [Accessed: 11-Mar-2018].
3. Flaster S, Lome LG, and Presman D. Urologic complications of renal papillary necrosis. Urology 1975;05(3):331–6.
4. Dagrosa LM, Ghali F, and Gormley EA. Renal Papillary necrosis appearing as bladder cancer on imaging. J Endourol 2016;2(1):27–29.
5. Vijayaraghavan SB, Kandasamy SV, Mylsamy A, and Prabhakar M. Sonographic features of necrosed renal papillae causing hydronephrosis. J. Ultrasound Med 2003;22(9)951–6; quiz 957–8.
6. Dunn DP, Kelsey NR, Lee KS, et al. Non-oncologic applications of diffusion-weighted imaging (DWI) in the genitourinary system. Abdom Imaging 2015;40(6)1645–54.
7. Jung DC, Kim SH, Il Jung S, et al. Renal papillary necrosis: review and comparison of findings at multi–detector row CT and intravenous urography. RadioGraphics 2006;26(6):1827–36.