GOOD NEWS: We have fixed the DICOM uploading problem. New cases should work fine. More info

Emphysematous pyelitis

Case contributed by Rania Adel Anan
Diagnosis certain


Diabetic patient presented with right flank pain

Patient Data

Age: 55 years
Gender: Female

Gas densities are predominantly noted within the upper and lower calyces of the right kidney. No intraparenchymal or perinephric extension of gas could be identified.​

Bilateral perinephric fat stranding noted.

Gas density forming air fluid level is also there within the full urinary bladder, with no intramural air in urinary bladder wall.

Vascular mural calcifications involving the celiac, superior mesenteric, renal, inferior mesenteric and iliac arteries also noted.

Gallbladder hyperdense stone is noted.

Case Discussion

The CT findings in a diabetic patient with flank pain are consistent with emphysematous pyelitis.

The lack of intraparenchymal air distinguishes this entity from emphysematous pyelonephritis, which carries a more grave prognosis and often requires surgical management.

 According to the Huang-Tseng CT classification system, this case can be classified as class 1.

CT is the best diagnostic modality for emphysematous pyelitis/pyelonephritis.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.