Cutting-Edge Approaches to Emphysematous Pyelonephritis: Diagnosis, Management, and Future Directions | Chapter 3 | Newer Frontiers in Urology

Introduction: Emphysematous Pyelonephritis (EPN) is a life-threatening infection characterized by gas formation within renal tissues, often associated with diabetes and immunocompromised states. Mortality rates were previously high, but advances in imaging, diagnosis, and treatment have improved outcomes.

Aim: This study aims to review recent advancements in EPN management, from early diagnosis to current therapeutic approaches, while identifying areas for future research and innovation.

Results: EPN is predominantly diagnosed in diabetic patients and those with urinary obstruction. Key pathogens include Escherichia coli and Klebsiella pneumoniae. Imaging, especially CT scan (Computed tomography), plays a critical role in classifying and managing EPN, with minimally invasive techniques such as percutaneous drainage emerging as effective interventions. Medical management, including strict glycaemic control and targeted antibiotics, has reduced the need for nephrectomy in lower-grade EPN cases.

Conclusion: Advances in EPN management—diagnostic imaging, minimally invasive interventions, and improved medical therapy—have decreased mortality and morbidity. Future directions include predictive analytics for early diagnosis and novel antibiotics for resistant pathogens.

 

Author (s) Details

 

Arvind Ramachandran
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Benjith Daniel F
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH3

Laparoscopic Pancreatic Pseudocystogastrostomy: A Case Study| Chapter 9 | Current Innovations in Medicine and Medical Science Vol. 8

 The most frequent results of both severe and chronic pancreatitis are pancreatic pseudocysts (PPC). Almost half of all cases resolve spontaneously, accompanying the remainder needing surgical intervention if indicative or complex. Open surgery and minimally invasive laparoscopic section are also opportunities for surgical intervention. However, endoscopic or percutaneous ultrasonic directed drainage is a feasibility. Three examples of pancreatic pseudocysts (PPC) are likely, all of which were treated completely via laparoscopic pancreatic pseudocystogastrostomy (LPPCG), accompanying other potential explored [1].Three cases of large pseudocyst of the organ meat are presented accompanying a similar lie and different age. All of them are bestowed as a complication of microlithiasis of gallbladder metals. All of them are bestowed as complications of gallbladder stone microlithiasis. Complete ancestry and biochemical tests were performed on the sufferers. The Ultrasonography was supplemented by an abdominal computed tomography (CT) to determine the links with the stomachic wall. All were preoperatively prepared and had posterior pancreatic pseudocystogastrostomy laparoscopic decorative running stitch performed. The medical checkup period was easy, and the patients had excellent judgment at 8 months, 2 years, and 6 age [2].A minimally invasive resection known as laparoscopic pancreatic pseudocystogastrostomy (LPPCG) has proven expected very effective in tiring and resolving pancreatic pseudocysts. This small succession investigation recognized no complications or recurrences, while the drama mentions only a small number of complications and depressed recurrence. In order to decide that it is the best minimally obtrusive approach for the treatment of the pancreatic pseudocyst, we advise bearing a large number of instances that are equal.

Author(s) Details:

Nezar A. Almahfooz,
Department of General Surgery, Almowasat Private Hospital, Basra, Iraq.

Please see the link here: https://stm.bookpi.org/CIMMS-V8/article/view/8726

Efficacy of Non Surgical Measures for Managing Pancreatic Ascites | Chapter 07 | New Horizons in Medicine and Medical Research Vol. 10

 Pancreatic ascites (PA) is an uncommon condition characterised by exudative fluid accumulation in the peritoneal cavity and high levels of amylase. Pancreatic ascites can occur as a result of pseudocyst rupture or ductal disruption in chronic calcific pancreatitis caused by alcohol misuse, tropical calcific pancreatitis, and other causes.

The goal of this case series is to assess the efficacy of nonsurgical interventions in the management of pancreatic ascites in carefully chosen cases.

Case Series: In this case series, we present three patients who developed pancreatic ascites as a result of non-ethanol-induced chronic calcific pancreatitis and were effectively managed without surgery. Image-guided percutaneous catheter drainage (PCD) and transpapillary pancreatic duct (PD) stent insertion were used to treat two instances of PA. The third instance was dealt with solely by PCD. PA was resolved in all three individuals.

Conclusion: In selected instances, conservative therapy with PCD and PD stent implantation aids in the successful control of PA with positive effects.

Author(S) Details

V. Katheresan
Department of Surgical Gastroenterology, GMKMCH, Salem, Tamil Nadu, India.

A. Sivasankar
Department of Surgical Gastroenterology, GMKMCH, Salem, Tamil Nadu, India.

M. Ponchidambaram
Department of Surgical Gastroenterology, GMKMCH, Salem, Tamil Nadu, India.

B. Kesavan
Department of Surgical Gastroenterology, GMKMCH, Salem, Tamil Nadu, India.

R. D. R. Somasekar
Department of Surgical Gastroenterology, GMKMCH, Salem, Tamil Nadu, India.

View Book:- https://stm.bookpi.org/NHMMR-V10/article/view/6959