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Emphysematous pyelitis and pneumoperitoneum

Case contributed by Dr Bruno Di Muzio


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

Patient Data

Age: 70 years
Gender: Female

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

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


CT Abdomen and pelvis

CT scan confirms the presence of multiple small calculi and gas foci in the renal pyelocaliceal systems 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
Published: 19th Oct 2014
Last edited: 25th Aug 2020
System: Urogenital
Inclusion in quiz mode: Included

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