Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Spontaneous intraperitoneal rupture of pyonephrosis in a patient with unknown kidney carcinosarcoma: a case report | Quaresima et al. World Journal of Surgical Oncology 2011 9 39 http content 9 1 39 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Spontaneous intraperitoneal rupture of pyonephrosis in a patient with unknown kidney carcinosarcoma a case report Silvia Quaresima Antonio Manzelli Edoardo Ricciardi Athanasios Petrou Nicholas Brennan Alessandro Mauriello and Piero Rossi Abstract Seventeen cases of peritonitis due to rupture of a pyonephrosis have been reported. The majority of these cases occur secondary to renal stones. Only two cases of ruptured pyonephrosis with concurrent kidney neoplasm have been described and only one of these presented as an acute peritonitis. In this presentation we discuss an unusual case of a 68 year old man with a chronic history of bilateral nephrolithiasis and recent pyonephrosis. He presented acutely with peritonitis and was later found to have a carcinosarcoma of the kidney. The case highlights the importance of recognizing the possibility of underling renal carcinoma in patients presenting with a ruptured pyonephrosis and discuss steps to avoid this serious complication. Background Peritoneal fistulization of a pyonephrosis is an extremely rare event which invariably leads to generalized peritonitis 1 . Rupture of a pyonephrotic kidney is usually associated with a previous kidney abnormality with hydropyonephrosis or pyonephrosis a common precipitator. Renal stones and much less commonly neoplasms may also cause rupture 2 . The renal origin of peritonitis is more often revealed intraoperatively as the clinical condition of the patient does not allow full urological investigation before laparotomy 3 . The aim of this paper is to present an unusual case of a 68 years old man with a previous history of gallstone pyonephrosis presenting with an acute abdomen and having a final diagnosis of renal carcinosarcoma. Case presentation A 68 years old man with a chronic history of bilateral nephrolithiasis was admitted to our
