Emphysematous pyelitis and pneumoperitoneum

Case contributed by Dr Bruno Di Muzio

Presentation

Asymptomatic patient came for CT scan to investigate renal stones. The patient had surgery to remove calculi 7 months earlier.

Patient Data

Age: 72
Gender: Female

One month earlier x-ray shows multiple calcified images in both pyelocaliceal system. It is possible to note gas around these stones.  

Ultrasound images demonstrate echogenic images that suggest stones. The strong shadow observed could be due the stones and also by the gas. 

CT

CT Abdomen and pelvis

CT scan confirms the presence of multiple small calculi and gas foci in the renal pyelocaliceal system and also the presence of pneumoperitoneum

Annotated image

Images showing the presence of multiple small stones associated with pyelocaliceal gas and also the presence of pneumoperitoneum. 

Case Discussion

Emphysematous pyelitis is defined as isolated gas production inside the excretory system, secondary to acute bacterial infection. It is generally benign, however it may be worsened in cases of late diagnosis that favors the involvement of the renal parenchyma (emphysematous pyelonephritis). 

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Case information

rID: 31484
Case created: 13th Oct 2014
Last edited: 19th Sep 2015
System: Urogenital
Inclusion in quiz mode: Included

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