Presentation
Vomiting and generalized pain abdomen for 2 days.
Patient Data
Age: 65 years
Gender: Female
From the case:
Emphysematous pyelonephritis
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/27415/annotated_viewer_json?iframe=true\u0026lang=us"}
Extensive air pockets in the left renal parenchyma and calyceal system. The gas tracks through the perirenal space into the posterior pararenal space.
Note: IV contrast was not given as the urea and creatinine values were high.
Rectal contrast was administered to rule out any large bowel pathology.
Case Discussion
Emphysematous pyelonephritis is a morbid infection of the kidneys, with characteristic gas formation within or around the kidneys. If not treated early, it may lead to fulminant sepsis with significant mortality.
Causative organisms include:
- E. Coli - usually considered the commonest causative organism
- Klebsiella pneumonia
- Proteus mirabilis