Abstract
Pyonephrosis is gross accumulation of pus within an obstructed renal collecting system
that, if left untreated, can lead to potentially fatal septic shock. Treatment requires
urgent decompression coupled with systemic antibiotics. Percutaneous nephrostomy (PCN)
placement, first described in 1976 for the treatment of pyonephrosis, is now widely
utilized for emergent decompression in these patients. When performed by an experienced
interventional radiologist, PCN is a safe procedure with technical success rates of
over 96 to 99%. This article will address the clinical presentation of pyonephrosis,
and will discuss the indications, technique, complications, and outcomes of emergent
PCN placement. Additionally, the expanded indications for PCN placement in nonemergent
scenarios will also be described.
Keywords
pyonephrosis - nephrostomy - hydronephrosis - nephrolithiasis - interventional radiology
