Lower abdominal pain, very tender, renal failure.
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The right kidney is abnormal with a dilated pelvicalyceal system that contain gas.
Extensive right perinephric fluid and fat stranding, also containing gas. This fluid may extend into the right psoas muscle and thus represents an abscess. Fat stranding around the right ureter.
The patient proceeded to nephrosotomy and frank pus was drained.
STANDARD BACTERIAL CULTURE 1. Escherichia coli 10^9 cfu/L