Presentation
Fever, flank pain and weight loss of unknown duration in a patient with diabetes and hypertension.
Patient Data
Findings include:
- gas-fluid level surrounding the right kidney.
- gas dissecting the right kidney.
- gas in the retroperitoneal space on the left side of vertebral bodies of T11, T12 and L1
These findings are consistent with the suspected diagnosis.
The right kidney shows focal necrotic areas, the presence of fluid and gas collections, and destroyed renal parenchyma which are classic findings for emphysematous pyelonephritis.
There is also gas in the retroperitoneal space that extends posterior to the pancreas and surrounds part of the contralateral kidney.
Case Discussion
With the findings on the CT Study, this case can be classified as a type 1 classification of emphysematous pyelonephritis. Findings that support this are:
- greater than one-third renal parenchymal destruction
- a very aggressive presentation that could lead to death shortly, if not treated early
The patient was admitted by urology and taken straight to surgery for a right total nephrectomy.
Unable to process the form. Check for errors and try again.