The left kidney is seen enlarged ins size shows multiple calyceal air density extending to its renal parenchyma with mild backpressure changes associated with perinephric fat stranding, yet no hyperdense stones noted along with the left urinary system.
A mild left hydroureter is noted with no underlying stones.
The right kidney is normal in site, size and orientation. No renal calculi, contour deforming abnormality or perinephric collection is detected.
The ureters and the urinary bladder are unremarkable.
The rest of visualized organs including the GB, CBD, pancreas, spleen, adrenals, and bowel loops show no gross abnormality, although this is a suboptimal study due to lack of contrast media.
No free air or significant lymphadenopathy detected.
Both lung bases are clear.
The visualized parts of the bones show no evidence of destructive lesion.
conclusion:
Type 2 left emphysematous pyelonephritis.