Emphysematous pyelonephritis

Discussion:

Advanced case of emphysematous pyelonephritis. The vast majority occur in those with diabetes mellitus and/or urolithiasis.

In this case it is present bilaterally and on the right has perforated the renal capsule to extend in the most profound fashion into the retroperitoneum. This is termed class 4: the highest class of the disease.

In fact, the gas serves to illustrate the anatomy of the retroperitoneal spaces and confines of Gerota's fascia.

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