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Surgery 2 - Third Year BHMS

Contents

Surgery 2 - Third Year BHMS

Contents

CoursesBHMSSurgery 2 - Third Year BHMSPYONEPHROSIS

PYONEPHROSIS

Content

PYONEPHROSIS

Pyonephrosis Definition, Clinical Features, Diagnosis and Management

Definition

Pyonephrosis refers to a severe inflammatory condition of the kidney, where a hydronephrotic kidney becomes infected and fills with pus.

Clinical Features

  • Severe flank pain
  • Pyrexia (fever)
  • Icterus (jaundice)
  • Anuria (failure to pass urine)
  • Uraemia (toxicity due to waste products)
  • Abdominal tenderness

Pathology

Pyonephrosis is characterized by:

  • Dilatation of the renal pelvis and calyces
  • Infection of the renal parenchyma
  • Suppuration (pus formation) in the renal parenchyma
  • Necrosis (death) of renal tissue

Types

Pyonephrosis can be classified into:

  • Acute pyonephrosis
  • Chronic pyonephrosis
  • Pyonephrosis associated with urinary tract obstruction

Causes

Causes of pyonephrosis include:

  • Urinary tract obstruction
  • Infection of the urinary tract
  • Congenital anomalies of the urinary tract
  • Trauma to the kidney
  • Tumors of the urinary tract

Investigations

Investigations for pyonephrosis include:

  • Ultrasound of the abdomen
  • Intravenous urography (IVU)
  • Computed tomography (CT) scan of the abdomen
  • Magnetic resonance imaging (MRI) of the abdomen
  • Urine analysis
  • Blood tests to check for infection and uraemia

Complications

Complications of pyonephrosis include:

  • Sepsis (blood infection)
  • Renal failure
  • Peritonitis (inflammation of the abdominal lining)
  • Abscess formation

Management

Management of pyonephrosis involves:

  • Antibiotic therapy
  • Urinary tract drainage
  • Decompression of the obstructed kidney
  • Nephrostomy (insertion of a tube into the kidney to drain urine)
  • Surgery to relieve the obstruction

Treatment

Treatment options for pyonephrosis include:

  • Conservative management (antibiotics and urinary tract drainage)
  • Surgical intervention (nephrostomy or surgery to relieve the obstruction)
  • Percutaneous nephrostomy (insertion of a tube into the kidney through the skin)

Homoeopathic Therapeutic Medicines

  • Aconitum napellus: for pain and inflammation
  • Arnica montana: for inflammation and trauma
  • Belladonna: for fever and inflammation
  • Bryonia alba: for pain and inflammation
  • Chamomilla: for anxiety and restlessness
  • Ferrum phosphoricum: for anemia and infection
  • Graphites: for skin and urinary tract symptoms
  • Lachesis: for pain and inflammation
  • Nux vomica: for nausea and vomiting
  • Pulsatilla: for female urinary tract symptoms

Indications:

  • Pyonephrosis
  • Urinary tract infection
  • Kidney stones
  • Renal colic
  • Painful urination

Note: The above list is not exhaustive and homoeopathic medicines should be used under the guidance of a qualified homoeopathic practitioner.