# Renal Abscess Drainage Using a Novel Transgastric Endoscopic Approach: A Case Report

**Authors:** Abby Kunitsky, Kevin D Kunitsky, Chase Cavayero, Augustine Salami

PMC · DOI: 10.7759/cureus.51294 · Cureus · 2023-12-29

## TL;DR

A new endoscopic method was used to drain a kidney abscess when other methods failed, offering a less invasive alternative.

## Contribution

The novel transgastric endoscopic ultrasound-guided stent placement for renal abscess drainage is introduced.

## Key findings

- A transgastric EUS-guided stent successfully drained a renal abscess after failed percutaneous attempts.
- The stent was removed after two days with significant abscess decompression.
- The patient was advised to follow up to confirm complete resolution.

## Abstract

Renal and perinephric abscesses are rare purulent infections within or around renal parenchyma, typically treated with antibiotics or various procedural approaches depending on abscess size. In this case report, we describe the novel use of a transgastric endoscopic ultrasound (EUS)-guided technique with placement of a stent for drainage between a renal abscess and the stomach in a patient who had failed attempted percutaneous drainage twice and where an open surgical approach was deemed inappropriate. The patient presented with a chief complaint of left flank pain, with CT revealing a ~4 x 4 cm renal abscess in the upper pole of the left kidney. Urology, Infectious Disease, and Interventional Radiology were consulted. Following two failed attempts at percutaneous drain placement, the patient elected for EUS-guided transgastric stent placement for drainage. The stent was removed by postoperative day two after significant decompression of the abscess. He was advised to follow up outpatient with Urology to confirm full renal abscess resolution.

## Full-text entities

- **Diseases:** liver cirrhosis (MESH:D008103), weight loss (MESH:D015431), diabetes mellitus (MESH:D003920), hepatic abscesses (MESH:D008100), hypoxic (MESH:D002534), urinary retention (MESH:D016055), intra-abdominal infection (MESH:D059413), ureteral obstruction (MESH:D014517), fistula in the gastrointestinal tract (MESH:D005770), pyuria (MESH:D011776), polycystic kidney disease (MESH:D007690), trauma (MESH:D014947), bacteriuria (MESH:D001437), Perinephric abscesses (MESH:D010501), pneumonia (MESH:D011014), leak (MESH:D019559), vomiting (MESH:D014839), kidney mass (MESH:D007674), hematuria (MESH:D006417), asthma (MESH:D001249), Azotemia (MESH:D053099), duodenal erosions (MESH:D004382), renal hematoma (MESH:D006406), bacteremia (MESH:D016470), necrotic neoplasm (MESH:D009369), Abscess (MESH:D000038), infection (MESH:D007239), mediastinitis (MESH:D008480), anorexia (MESH:D000855), kidney stone (MESH:D007669), hypoxia (MESH:D000860), pain (MESH:D010146), pancreatic pseudocyst (MESH:D010192), shoulder pain (MESH:D020069), Infectious Disease (MESH:D003141), chills (MESH:D023341), gastric antral erosions (MESH:D020252), atelectasis (MESH:D001261), lethargy (MESH:D053609), costovertebral angle tenderness (MESH:D063806), cyst (MESH:D003560), Leukocytosis (MESH:D007964), urinary tract infection (MESH:D014552), nausea (MESH:D009325), renal cell carcinoma (MESH:D002292), pyelonephritis (MESH:D011704), abdominal pain (MESH:D015746), flank pain (MESH:D021501), vesicoureteral reflux (MESH:D014718), pleural effusion (MESH:D010996), urinary tract abnormalities (MESH:D014570), fever (MESH:D005334), dysuria (MESH:D053159), junction (MESH:D020511)
- **Chemicals:** ketorolac (MESH:D020910), lactic acid (MESH:D019344), nitrites (MESH:D009573), contrast extravasation (-), vancomycin (MESH:D014640), creatinine (MESH:D003404), Isovue (MESH:D007479), ceftriaxone (MESH:D002443), piperacillin/tazobactam (MESH:D000077725), polypropylene (MESH:D011126), ciprofloxacin (MESH:D002939)
- **Species:** Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Homo sapiens (human, species) [taxon 9606], Proteus (genus) [taxon 210425], Escherichia coli (E. coli, species) [taxon 562], Klebsiella (genus) [taxon 570], Staphylococcus aureus (species) [taxon 1280], Cutibacterium acnes (species) [taxon 1747], Pseudomonas (RNA similarity group I, genus) [taxon 286]

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC10822679/full.md

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC10822679/full.md

## References

20 references — full list in the complete paper: https://tomesphere.com/paper/PMC10822679/full.md

---
Source: https://tomesphere.com/paper/PMC10822679