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A 45-year-old Diabetic man with left loin pain, fever and chills.

Plain (no IV or oral contrast) Helical CT scan of the abdomen was done after an abnormality was suspected on the abdominal plain radiograph and ultrasonogram.

Curved Coronal reformatted NECT image.

A very simple straight forward diagnosis.

Continue reading below the fold….

Findings:

Dilated left renal collecting system and proximal ureter containing air. A calculus is seen in the proximal ureter. Distal ureter shows normal caliber with no luminal air. Small air pockets are seen in the left renal parenchyma lateral to the renal pelvis. Mild oedema in the retroperitoneal fat around the proximal left ureter.

Diagnosis:

Emphysematous Pyelonephritis in an obstructed kidney.

A similar reformatted NECT image in a patient with a non-infected obstructed left collecting system is shown below.

Read more about Emphysematous Pyelonephritis here, here & here.

And about its diagnosis on MDCT here.

A pictorial review of all emphysematous infections of the abdomen & pelvis can be found here.

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