Minimally invasive treatment of a purulent focus
Kidney carbuncles up to 3 cm in size and small apostemes identified by ultrasound and MSCT can be cured without open dissection: under ultrasound guidance, a needle is inserted into the lesion, pus is aspirated (culture determines the pathogen and sensitivity), the cavity is washed and filled with an antibiotic solution, which is also injected into the surrounding tissue. The procedure is repeated after 2–3 days while the lesion remains intact. If the abscess exceeds 3–4 cm or does not decrease, percutaneous drainage with a tube is performed. At the same time, intravenous antibiotic therapy is continued and obstruction, if any, is eliminated.
Why administer an antibiotic to the kidney?
In acute pyelonephritis with severe swelling of the kidney and perinephric tissue, apostematous pyelonephritis and a developing carbuncle, systemic antibiotics do not always reach the lesion in the required concentration. The introduction of an antibiotic solution with an anesthetic directly into the perinephric tissue creates a high local concentration, relieves spasm and pain (blockade) and accelerates the reverse development of inflammation. The method complements, rather than replaces, intravenous therapy.
Security
The puncture is performed under ultrasound guidance with a thin needle, which eliminates damage to blood vessels and intestines. Contraindications: coagulation disorders and allergies to drugs. If a formed abscess is detected, drainage is performed instead of injection. The procedure is repeated 1-3 times with an interval of 2-3 days according to the dynamics.
