Litíase Renal em Adolescente Evoluindo com Pielonefrite Crônica e Fístula Renocutânea: Relato de Caso/ Nephrolithiasis Teenager and Chronic Pyelonephritis Evolving to Renocutaneo us Fistula: Case Report
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Abstract
Introdução: Litíase renal é a formação de cálculos no trato urinário que resulta de fatores epidemiológicos, anatômicos e modificações físico-químicas da urina, por alterações urodinâmicas. A presença de cálculos no trato urinário favorece a proliferação bacteriana e leva ao quadro de pielonefrite crônica. Como complicação desse quadro infeccioso, surge o abscesso renal e peri-renal. Casuística: Relata-se um caso de fístula renocutânea relativamente pouco frequente no curso de uma pielonefrite crônica por cálculo coraliforme, perfurando a pelve renal em paciente masculino de 14 anos. Discussão: O caso relatado mostra de forma sequenciada a evolução desfavorável de uma pielonefrite crônica, causada por nefrolitíase em criança. As queixas relatadas e os sinais/sintomas evidenciados servem para nos orientar na tentativa de diagnósticos cada vez mais precoces. Conclusão: Os exames complementares devem ser solicitados com ponderação, mas não omitidos, em caso de dúvidas quanto ao diagnóstico.
Palavras-chave: Pielonefrite Crônica; Fístula Renocutânea; Litíase Renal
ABSTRACT
Introduction: Renal lithiasis is the formation of calculi in the urinary tract that results of epidemiologic factors, anatomical and physico-chemical changes in the urine urodynamic changes. The presence of calculi in the urinary tract favors bacterial proliferation and leads to chronic pyelonephritis. As a complication of infection, abscess arises renal and peri-renal. Case report: We report a case of fistula renocutânea relatively uncommon in the course of chronic pyelonephritis with staghorn calculus piercing the renal pelvis in a male patient of 14 years. Discussion: This case shows the sequenced so unfavorable a chronic pyelonephritis, caused by nephrolithiasis in children. Complaints reported and signs/symptoms evidenced serve to guide us in trying to increasingly earlier diagnoses. Conclusion: The exams must be requested in weight, but not omitted in case of doubt about the diagnosis.
Keywords: Chronic pyelonephritis; Renocutaneous fistula, Renal lithiasis
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