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Ultrasonography of Perinephric Fluid: Differential Diagnosis and Image Interpretation

      Objectives

      Perinephric fluid is a critical finding of ultrasonography in daily clinical practice. The condition includes a broad spectrum of diseases and the fluid may arise from the kidney or adjacent retroperitoneal structures. We present a case series of patients with perinephric fluid collection with ultrasound images. The brief history, physical examination and image interpretation are addressed as well as the images of subsequent other modalities.

      Methods

      Case series and literature review.

      Results

      Cases of pyelonephritis with abscess, obstructive uropathy with perirenal urine leakage, renal laceration with hematoma, pseudoaneurysm and perirenal lymphangiomatosis were reviewed. In most cases, the distinguishing ultrasound characteristics about the fluid shape, internal echogenicity, or the Doppler signal serve as clues to the astute sonographer to search more carefully for an underlying disease.

      Conclusions

      Perinephric fluid includes a broad spectrum of diseases and ultrasonography plays an important role of management at the point of care.