{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:15:33Z","timestamp":1793412933700,"version":"4.5.0"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002714","name":"Albert-Ludwigs-Universit\u00e4t Freiburg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002714","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Nontraumatic renal rupture due to pyelonephritis with obstructive uropathy is an uncommon but life-threatening situation.<jats:italic> Case Presentation<\/jats:italic>. A 25-year-old female presented to the emergency department with acute worsening of abdominal pain that began four weeks earlier. She was found to have peritonitis, leukocytosis, severe lactic acidosis, and a pronounced anemia and imaging was consistent with nontraumatic renal rupture with retroperitoneal abscess, perforation of the colon, and severe necrotizing fasciitis of the right lower limb. She underwent a right nephrectomy, a right hemicolectomy, surgical debridement of the retroperitoneum, and an upper thigh amputation. Due to severe septic shock and rhabdomyolysis with acute renal failure we performed a combined treatment of hemoadsorption using a Cytosorb hemoadsorber and continuous venovenous hemodialysis (CVVHD). Subsequently the patient recovered and was discharged home with no signs of infections and with normal renal function.<jats:italic> Conclusion<\/jats:italic>. We present a case of pyelonephritis with nontraumatic renal rupture leading to necrotizing fasciitis with osteomyelitis of the lower limb. The early treatment of the patient with a Cytosorb hemoadsorber led to a rapid hemodynamic and metabolic stabilization and preservation of the renal function, suggesting that hemoadsorption might be a rescue therapy in patients with severe septic shock and traumatic rhabdomyolysis.<\/jats:p>","DOI":"10.1155\/2018\/5248901","type":"journal-article","created":{"date-parts":[[2018,4,29]],"date-time":"2018-04-29T19:31:30Z","timestamp":1525030290000},"page":"1-4","source":"Crossref","is-referenced-by-count":6,"title":["Hemoadsorption in a Case of Severe Septic Shock and Necrotizing Fasciitis Caused by Nontraumatic Renal Rupture due to Pyelonephritis with Obstructive Uropathy"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9706-7345","authenticated-orcid":true,"given":"Lampros","family":"Kousoulas","sequence":"first","affiliation":[{"name":"Department of General and Visceral Surgery, Medical Center, University of Freiburg Faculty of Medicine, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Wittel","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Medical Center, University of Freiburg Faculty of Medicine, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Fichtner-Feigl","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Medical Center, University of Freiburg Faculty of Medicine, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Utzolino","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Medical Center, University of Freiburg Faculty of Medicine, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2008.03.011"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-7071(96)00079-4"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1080\/00365590410018648"},{"issue":"11","key":"4","first-page":"781","volume":"75","year":"1982","journal-title":"Zeitschrift f\u00fcr Urologie und Nephrologie"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410x.2011.10164.x"},{"issue":"2","key":"6","first-page":"65","volume":"13","year":"2011","journal-title":"Reviews in Urology"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.203.3.9169717"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2014.00036"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1662-9"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-111965"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2018\/5248901.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2018\/5248901.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2018\/5248901.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,4,29]],"date-time":"2018-04-29T19:31:33Z","timestamp":1525030293000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/cricc\/2018\/5248901\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":10,"alternative-id":["5248901","5248901"],"URL":"https:\/\/doi.org\/10.1155\/2018\/5248901","relation":{},"ISSN":["2090-6420","2090-6439"],"issn-type":[{"value":"2090-6420","type":"print"},{"value":"2090-6439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018]]}}}