June 1978

Obstructive Jaundice and Perinephric Abscess

Author Affiliations

Edgerton, Wis

Arch Surg. 1978;113(6):778. doi:10.1001/archsurg.1978.01370180120029

Only four cases of obstructive jaundice secondary to varying renal problems have been recorded.1 A fifth case, due to perinephric and periureteral abscess, is reported here.

Report of a Case.—A 79-year-old woman had been admitted eight months previously with contusion of the abdominal wall. Roentgenographic studies fortuitously included an intravenous pyelogram interpreted normal. Readmission in July 1973 was for right upper quadrant and shoulder pain of several weeks' duration. Her urine had been dark and the stools light. There was no prior history of icterus despite food intolerances. Temperature was 38.9° C; heart rate, 120 beats per minute. The patient was grossly icteric, and the total bilirubin level was 10.1 mg/dl. The SGOT, SGPT, alkaline phosphatase, and WBC values were elevated. There was tenderness in the right upper quadrant. Upper gastrointestinal series showed "air-bubble-like densities" in the right upper quadrant, interpreted as probable subdiaphragmatic or hepatic abscess.


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