title: Xanthogranulomatous Pyelonephritis with Staghorn Calculus, Acute Gangrenous Appendicitis and Enterocolitis: A Multidisciplinary Challenge of Kidney-Preserving Conservative Therapy.
abstract: Xanthogranulomatous pyelonephritis (XP) is a rare form of pyelonephritis and without treatment destructive to the kidney. We describe a 74-year-old Caucasian immunocompetent female patient with XP and multiple abscesses on the upper pole of the right kidney and several impacted obstructing renal calculi in the middle calyx that developed severe colitis and gangrenous appendicitis during therapy. Proteus mirabilis was detected as the major pathogen in the urine culture. Kidney preserving therapy was carried out by intensive parenteral bacterial eradication, CT-guided abscess drainage and stone destruction by 3 sessions of extracorporeal shock wave lithotripsy under ureteral stenting. Large tumor masses in XP are often daunting and may lead to a nephrectomy. However, kidney-preserving therapy is possible and should be considered in non-septic patients or in case of a solitary kidney.
authors.affiliation: Department of Urology, Hospital Göttlicher Heil, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Friedl
authors.affiliation: Department of Urology/Stone Center, Rudolfstiftung Hospital Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Tuerk
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hospital Göttlicher Heiland; Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schima
authors.affiliation: Department of Urology, Hospital Göttlicher Heil, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Broessner
keywords: Kidney preserving therapy; Staghorn calculi; Xanthogranulomatous pyelonephritis