Presentation
Diabetic patient with dysuria and history of recurrent urinary tract infection.
Patient Data
There is a left double-J ureteric stent placed associated with mild dilatation of the left pelvicalyceal system and left ureter.
Multiple linear echogenic shadows are seen inside the left renal pelvis and calyces associated with shadowing. Few similar shadows are seen in the urinary bladder as well showing change in location with changing patient decubitus in keeping with air/gas shadows.
The left double-J ureteric stent is seen in place with evidence of air/gas density within the mildly dilated left renal pelvicalyceal system and along the course of the stent.
No radio-opaque stones along the urinary tract.
Post-cholecystectomy surgical clips are seen.
Case Discussion
Emphysematous pyelitis is the production of gas within the urinary excretory system without involvement of the renal parenchyma, commonly secondary to E. coli infection in diabetic patients.
This patient was a case of uncontrolled diabetes with E. coli confirmed in the urine culture.