Abstract

DIAZ TELLI, Federico et al. Empyema of the Ureteral Stump: Secrets for a Correct Diagnosis. Rev. argent. radiol. [online]. 2019, vol.83, n.2, pp.71-76. ISSN 1852-9992.  http://dx.doi.org/https://doi.org/10.1055/s-0039-1692152.

The ureteral stump is the segment of the ureter that remains after a nephrectomy, and it can occasionally give rise to a rare symptomatic infectious disorder known as an empyema of the ureteral stump. The syndrome is usually attributed to another disease due to the radiologist's or ED physician's unawareness, and diagnosis is delayed until there is significant clinical progression, complimentary images or exploratory surgery is performed. Ureteral stumps that were healthy at the initial surgery, usually do not pose further problems. On the other hand, ureters that are obstructed, chronically infected or associated with nephrolithiasis or distal reflux, are at risk for developing future complications. This review goes over the available literature on the subject and presents cases of patients who underwent a nephrectomy and, for different reasons, developed an empyema of the ureteral stump in order analyze the possible causes and predisposing factors, describing the main radiologic findings in each of the different imaging modalities, and recognize the possible complications and their according therapeutic management. Repeated urinary tract infections are useful for suspecting the presence of an empyema, and are due to vesicoureteral reflux or ureteral dysfunction, with consequent urinary stasis and infection. Thus, patients with a history of nephrectomy presenting with diffuse abdominal pain, fever and repeat urinary infections, should raise the suspicion of empyema of the ureteral stump, leading to a correct imaging analysis and posterior treatment.

Keywords : empyema; nephrectomy; infection; low back pain.

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