Emphysematous pyelonephritis

Case contributed by Dr Ian Bickle

Presentation

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

Patient Data

Age: 47
Gender: Female
Modality: X-ray

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

No renal tract stones.

Modality: CT

Extensive right intraparenchymal and perinephric gas.

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

No renal tract stones.

Case Discussion

Pneumoretroperitoneum is much more uncommon than pneumoperitoneum.

One less frequently identified cause is from emphysematous pyelonephritis - especially as profound as on this study.

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

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Case Information

rID: 39632
Case created: 13th Sep 2015
Last edited: 9th May 2017
System: Urogenital
Inclusion in quiz mode: Included

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