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Acute pyelonephritis

Case contributed by James Sheldon
Diagnosis probable

Presentation

Right iliac fossa pain with fever. Past history of diverticulitis.

Patient Data

Age: 85 years
Gender: Female
ct

The right kidney is bulky and demonstrates areas of reduced enhancement. Perirenal fat stranding.

Pneumobilia is likely secondary to previous sphincterotomy. Previous cholecystectomy. There is colonic diverticulosis without evidence of acute diverticulitis.

There is fat stranding and gas within the subcutaneous fat of the right groin consistent with the provided history of recent femoral artery puncture.

 

Case Discussion

CT features of: 

  • Patchy areas of reduced enhancement in the right kidney are consistent with acute pyelonephritis.
  • Left upper pole exophytic enhancing mass consistent with renal cell carcinoma.

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