EURORAD ESR

Case 956

Emphysematous Pyelonephritis

Author(s)
C. Uithol, K.W. Florijn, T. Kwast van der, G. Risseeuw
 
Patient
female, 32 year(s)
 
 
  • Figure 1
    Plain radiograph of the left hemi-abdomen

    shows air bubbles in a radial, streaky configuration within the upper pole of the left kidney.

     
    Area of Interest: unknown; Imaging Technique: Plain radiograph of the left hemi-abdomen;
     
     
  • Figure 2
    Native CT scan of the left kidney

    demonstrates extensive intrarenal gas, distributed predominantly in the cortical region of the kidney. Linear low-density areas within the renal parenchyma and thickening of the renal fascia and enlargement of the...

     
    Area of Interest: unknown; Imaging Technique: Native CT scan of the left kidney;
     
     
  • Figure 3
    Macroscopy of the resected kidney

    Macroscopy of the resected kidney shows multiple subcapsular and cortical abscesses in the upper and middle pole of the kidney.

     
    Area of Interest: unknown; Imaging Technique: Macroscopy of the resected kidney;
     
     
  • Figure 4
    Microscopy of the left kidney

    shows severe hyalinisation of renal capillaries in the non-affected renal parenchyma. Air in the left kidney, seen on plain radiograph and CT scan, was virtually pathognomonic for emphysematous pyelonephritis. The...

     
    Area of Interest: unknown; Imaging Technique: Microscopy of the left kidney;
     
     
shows air bubbles in a radial, streaky configuration within the upper pole of the left kidney.
 
demonstrates extensive intrarenal gas, distributed predominantly in the cortical region of the kidney. Linear low-density areas within the renal parenchyma and thickening of the renal fascia and enlargement of the posterior perinephric space are seen.
 
Macroscopy of the resected kidney shows multiple subcapsular and cortical abscesses in the upper and middle pole of the kidney.
 
shows severe hyalinisation of renal capillaries in the non-affected renal parenchyma. Air in the left kidney, seen on plain radiograph and CT scan, was virtually pathognomonic for emphysematous pyelonephritis. The diagnosis was confirmed pathohistologically and left nephrectomy was performed. The postoperative course was uneventful. Patient recovered completely and was discharged from the hospital in good condition.
 
 
 
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