According to Huang-Tseng CT classification system, how would you classify this condition?
Class 1: gas in collecting system only. Class 2: gas in renal parenchyma only (without extrarenal extension). Class 3a: extension of gas or abscess to perinephric space. Class 3b: extension of gas or abscess to pararenal space. Class 4: bilateral emphysematous pyelonephritis or solitary kidney with emphysematous pyelonephritis.
Extensive, bilateral, streaks and loculated gas, involving both renal parenchyma, pelvicalyceal system, proximal ureter and perirenal space.
Evidence of renal parenchymal destruction on both sides and extensive perirenal fat stranding.
Features are those of severe bilateral emphysematous pyelonephritis.
Free fluid is noted in the pararenal spaces as well as pelvis.