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A perinephric abscess may be pyogenic or tuberculous, and may arise from a spinal infection: radiographs of the vertebrae may be necessary. Such abscesses are not uncommon and vary greatly in size. The echo patterns can be very variable (Fig. 48.75).

Fig. 48.75. (A) Perinephric abscess. (B) Huge, round left perinephric abscess found alongside a viable, unsuspected 24-week pregnancy. (C, D) Necrotic, pyogenic right ectopic kidney (probably due to torsion) with ascites, misdiagnosed as a gangrenous intussusception, in spite of the fact that absence of a normal right kidney was noted. (E) Perinephric abscess. I necrotic, pyogenic mass; FF ascites; U uterus; AB abscess; LK and RK kidneys.

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