title: [A rare complication of renal lithiasis: peritonitis and splenic abscess caused by rupture of pyonephrosis].
abstract: Peritonitis can result from many causes. We report a case caused by a renal abscess which contaminated the abdominal cavity. A 30-year-old patient was referred with suspected ruptured ectopic pregnancy with signs of peritoneal flooding. The culdocentesis was positive and returned frank pus. Endoscopic exploration with an open laparoscope revealed that the infection did not originate from a gynecological infection but did not identify the exact origin. Laparotomy was performed and revealed a splenic abscess and a subphrenic peritoneal breach releasing a purulent liquid. Splenectomy and abdominal lavage with draining was performed. A post-operative pyelourogram showed a silent kidney with multiple coralliform lithiases. Interventional sonography allowed drainage of a retroperitoneal collection. The post-operative period was uneventful. Left nephrectomy was later performed. Only rare cases of ruptured pyonephrosis leading to peritonitis have been reported, usually with poor prognosis.
authors.affiliation: Centre de Maternité et de Néonatalogie de la Rabta, Service A, Tunis.
authors.forename: M S
authors.initials: MS
authors.lastname: Hendaoui
authors.forename: A
authors.initials: A
authors.lastname: Abed
authors.forename: W
authors.initials: W
authors.lastname: M'Saad
authors.forename: H
authors.initials: H
authors.lastname: Chelli
authors.forename: L
authors.initials: L
authors.lastname: Hendaoui
mesh_terms: D000038:Abscess / Q000150:complications* / Q000601:surgery; D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D010538:Peritonitis / Q000209:etiology*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000150:complications*; D011704:Pyelonephritis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D012422:Rupture, Spontaneous; D013156:Splenectomy; D013158:Splenic Diseases / Q000150:complications* / Q000601:surgery; D014057:Tomography, X-Ray Computed
vernacular_title: Une complication rare des lithiases rénales: péritonite et abcès splénique par rupture d'une pyonéphrose.