Ishtiaq A Chaudhry.
Intraperitoneal Rupture of Perinephric Abscess.
Pak J Surg Jan ;18(1):35-7.

Rupture of perinephric abscess into peritoneal cavity is very rare. A case of generalized peritonitis due to rupture of perinephric abscess into peritoneal cavity is being reported, which was diagnosed at laparotomy.

A 56 year old lady was admitted in emergency with two days history of fever, pain all over abdomen, abdominal distension and constipation. She had left renal calculus and UTI for which she was regularly getting treatment from urologist. On clinical examination she was toxic, febrile and dehydrated. Her abdomen was grossly distended, having tenderness and guarding with no bowel sounds. X-ray plain abdomen shows free gas under both domes of diaphragm. On clinical suspicion of viscus perforation emergency laparotomy was performed. Abdomen was full of pus and all abdominal viscera were normal. After through exploration it was noticed that the pus was coming from a sinus lateral to descending colon, which was in communication with left perinephric space resulting from rupture of perinephric abscess into peritoneal cavity. Thorough peritoneal toilet and free drainage of abscess was done and abdomen closed with drains.

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