Computed tomography in emphysematous pyelonephritis
Erden Erol Ünlüer, Arif Karagöz
The Pan African Medical Journal. 2015;22:186. doi:10.11604/pamj.2015.22.186.7902

Create an account  |  Sign in
African Case Studies Case studies in Public health
"Better health through knowledge sharing and information dissemination "

Images in medicine

Computed tomography in emphysematous pyelonephritis

Cite this: The Pan African Medical Journal. 2015;22:186. doi:10.11604/pamj.2015.22.186.7902

Received: 06/09/2015 - Accepted: 17/10/2015 - Published: 23/10/2015

Key words: Emphysematous pyelonephritis, computed tomography, emergency

© Erden Erol Ünlüer et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/22/186/full

Corresponding author: Erden Erol Ünlüer, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Department of Emergency Medicine, Karabaglar, Izmir, Turkey (erolerdenun@yahoo.com)


Computed tomography in emphysematous pyelonephritis

 

Erden Erol Ünlüer1,&, Arif Karagöz1

 

1Izmir Katip Çelebi University Atatürk Training and Research Hospital, Department of Emergency Medicine, Karabaglar, Izmir, Turkey, 2Izmir Karsiyaka State Hospital, Emergency Department, Karsiyaka, Izmir, Turkey

 

 

&Corresponding author
Erden Erol Ünlüer, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Department of Emergency Medicine, Karabaglar, Izmir, Turkey

 

 

Image in medicine

A 44-year-old woman presented to our emergency department with fever, right flank and abdominal pain for one week. Her past medical history depicted that she had asthma and newly diagnosed diabetes. Direct abdominal X-ray revealed hyperlucent areas in the right kidney lodge (A). Abdominal computed tomography (CT) with contrast showed free gas collection with fatty infiltration outlining the right perirenal space (B). Right kidney also had increased attenuation comparing to the left one. The patient was admitted to the urology department with the diagnose of sepsis due to emphysematous pyelonephritis. Right nephrectomy was recommended to the patient with intravenous antibiotics and drainage. Several classification systems have been proposed to correlate imaging findings with subsequent prognosis and management in patients with emphysematous pyelonephritis. The mildest forms are confined to collecting system or form loculated air-fluid collections in or adjacent kidneys. This may be amenable to percutenous drainage. The more severe infections are characterized by spread of gas into the renal paranchyma and can extend into the perinephric and paranephric spaces and often require emergency nephrectomy as occured in our case. Conventional radiographs may demonstrate a cluster of mottled lucencies within the kidneys.

 

 

Figure 1: (A) abdominal X-ray and computed tomography showing emphysematous pyelonephritis; (B) ultrasonography shows echogenic foci with ’’dirty’’ shadowing within the kidneys; on CT the collections of gas are seen directly as hypoattenuating foci in the renal lodge

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


The Pan African Medical Journal articles are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 27 (May - August 2017)

Article tools

This article authors

On Pubmed
On Google Scholar

Navigate this article

Rate this article

Altmetric

Popular articles in Images in medicine

PAMJ is a member of the Committee on Publication Ethics

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved