Emphysematous pyelonephritis - bilateral
Diabetes, flank pain.
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Replacement of much of the right kidney with gas. Retroperitoneal and collecting system gas. Surround fluid/stranding. Small ascites. Less severe involvement of the left kidney with perinephric collections containing gas.
Bilateral involvement demonstrating the variety of severity of emphysematous pyelonephritis, with diffuse cortical destruction on the right and more minor involvement on the left centered on perinephric collections.