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Emphysematous pyelonephritis

Case contributed by Dr Ian Bickle

Presentation

Diabetic. Fever, right flank pain and dysuria. Abnormal urine dipstick.

Patient Data

Age: 45 years
Gender: Female
X-ray

Large volume of gas in the right retroperitoneum, largely along the medial perinephric space.

No renal tract stones.

CT

Extensive right intraparenchymal and perinephric gas.

Edematous right kidney, with minor prominence of the collecting system.  Right perinephric inflammatory change.

No renal tract stones.

Case Discussion

Pneumoretroperitoneum is much less common than pneumoperitoneum.

A less frequent cause is from emphysematous pyelonephritis - especially as profound as on this study.

The patient is nearly always diabetic - an obstructing stone may be the trigger - but not always - as in this case.

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Case information

rID: 39632
Published: 14th Sep 2015
Last edited: 30th Aug 2020
System: Urogenital
Inclusion in quiz mode: Included

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