emphysematous pyelitis

Emphysematous
pyelonephritis in a solitary kidney. Three weeks later, after ureteral stenting (arrowheads), multiplanar CT images showed appearance of multiple, sizeable gaseous and fluid intraparenchymal collections in the right kidney.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. T2-(a-b, fat-suppressed c...e) and T1-weighted (f-g) images confirmed enlarged oedematous right kidney with fluid-like collections (*) and low-signal intensity portions corresponding to gas.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Further follow-up CT (e..g) seven weeks after onset showed further decrease of renal emphysematous changes. Note ureteral stent still in place (arrowheads).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Three weeks later, after ureteral stenting (arrowheads), multiplanar CT images showed appearance of multiple, sizeable gaseous and fluid intraparenchymal collections in the right kidney.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Three weeks later, after ureteral stenting (arrowheads), multiplanar CT images showed appearance of multiple, sizeable gaseous and fluid intraparenchymal collections in the right kidney.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. T2-(a-b, fat-suppressed c...e) and T1-weighted (f-g) images confirmed enlarged oedematous right kidney with fluid-like collections (*) and low-signal intensity portions corresponding to gas. Note hypoplastic left kidney (thick arrow).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Repeated CT (b...d) three weeks after Fig.3 showed partial decrease of fluid and gaseous intrarenal collections. Note ureteral stent in place (arrowheads).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. T2-(a-b, fat-suppressed c...e) and T1-weighted (f-g) images confirmed enlarged oedematous right kidney with fluid-like collections (*) and low-signal intensity portions corresponding to gas.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. T2-(a-b, fat-suppressed c...e) and T1-weighted (f-g) images confirmed enlarged oedematous right kidney with fluid-like collections (*) and low-signal intensity portions corresponding to gas.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. T2-(a-b, fat-suppressed c...e) and T1-weighted (f-g) images confirmed enlarged oedematous right kidney with fluid-like collections (*) and low-signal intensity portions corresponding to gas.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Three weeks later, after ureteral stenting (arrowheads), multiplanar CT images showed appearance of multiple, sizeable gaseous and fluid intraparenchymal collections in the right kidney. Note hypoplastic left kidney (thick arrow).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. T2-(a-b, fat-suppressed c...e) and T1-weighted (f-g) images confirmed enlarged oedematous right kidney with fluid-like collections (*) and low-signal intensity portions corresponding to gas.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Follow-up ultrasound showed strongly echoic bands (thick arrows) with distal reverberation artefacts corresponding to persistence of intrarenal air collections.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Repeated CT (b...d) three weeks after Fig.3 showed partial decrease of fluid and gaseous intrarenal collections. Note ureteral stent in place (arrowheads).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Repeated CT (b...d) three weeks after Fig.3 showed partial decrease of fluid and gaseous intrarenal collections. Note ureteral stent in place (arrowheads).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
Pyelonephritis. Axial CT showed collections of air within the central collecting system with the gas clearly outlining the dilated calyces
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis • Emphysematous pyelitis and pyelonephritis - Ganzer Fall bei Radiopaedia
Ashraf A, Emphysematous pyelitis and pyelonephritis. Case study, Radiopaedia.org (Accessed on 16 Jul 2023) https://doi.org/10.53347/rID-166853 • CC by-nc-sa 3.0 (modified)
Emphysematous
pyelitis vs emphysematous pyelonephritis. Coronal view showing calculus and emphysema around it. Emphysema localised in the collecting system. No involvement of renal parenchyma and perirenal fat.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelitis vs emphysematous pyelonephritis. Axial view showing pericalyceal emphysema.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelitis vs emphysematous pyelonephritis. Sagittal view showing calculus surrounded by emphysema.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelitis vs emphysematous pyelonephritis. Post JJ-stenting showing no change in renal calculus with subtotal regression of emphysema.
www.eurorad.org • CC by-nc-sa-4.0
Hematuria and
fever in a patient with polycystic kidney disease, a case report. An axial image at the level of the kidneys shows bilateral enlarged polycystic kidneys with an extensive gas collection in the right kidney (arrow), distributed along the pyelocalyceal system.
www.eurorad.org • CC by-nc-sa-4.0
Hematuria and
fever in a patient with polycystic kidney disease, a case report. An axial image at the level of the kidneys demonstrates intraparenchymal gas in the right kidney, partially located in the wall of some renal cysts (arrows).
www.eurorad.org • CC by-nc-sa-4.0
Hematuria and
fever in a patient with polycystic kidney disease, a case report. A coronal CT image demonstrates the extensive amount of renal gas in the right kidney, located in the wall of some cysts (arrow) and intracalyceal (arrowhead).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis • Emphysematous pyelonephritis and pyonephrosis - Ganzer Fall bei Radiopaedia
Bickle I, Emphysematous pyelonephritis and pyonephrosis. Case study, Radiopaedia.org (Accessed on 23 Feb 2023) https://doi.org/10.53347/rID-29648 • CC by-nc-sa 3.0 (modified)
Emphysematous
Pyelonephritis. Coronal CT showed collections of air within the central collecting system with the gas clearly outlining the dilated calyces
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
Pyelonephritis. Sagital CT showed collections of air within the central collecting system with the gas clearly outlining the dilated calyces
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Further follow-up CT (e..g) seven weeks after onset showed further decrease of renal emphysematous changes. Note ureteral stent still in place (arrowheads).
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. T2-(a-b, fat-suppressed c...e) and T1-weighted (f-g) images confirmed enlarged oedematous right kidney with fluid-like collections (*) and low-signal intensity portions corresponding to gas.
www.eurorad.org • CC by-nc-sa-4.0
Emphysematous
pyelonephritis in a solitary kidney. Three weeks later, after ureteral stenting (arrowheads), multiplanar CT images showed appearance of multiple, sizeable gaseous and fluid intraparenchymal collections in the right kidney.
www.eurorad.org • CC by-nc-sa-4.0
Hematuria and
fever in a patient with polycystic kidney disease, a case report. CT-classification of emphysematous pyelonephritis according to Wan et al. and the more recent classification according to Huang and Tseng [4-5].
www.eurorad.org • CC by-nc-sa-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Emphysematous pyelitis is isolated gas production inside the excretory system, secondary to acute bacterial infection. It is a relatively benign entity and needs accurate differentiation from the far more serious emphysematous pyelonephritis, which is gas production from an infection in the renal parenchyma rather than just in the collecting system.

Epidemiology

Emphysematous pyelitis is more common in females . Risk factors include diabetes mellitus and urinary tract obstruction.

Clinical presentation

Symptoms are usually mild, with fever and chills. Sometimes flank tenderness with dysuria is present.

Pathology

Etiology

E. coli, Klebsiella, Aerobacter aerogenes, and Proteus mirabilis are the commonest causative organisms.

Radiographic features

Plain radiograph

Retroperitoneal gas is seen in many patients. Associated urolithiasis, if any, may also be seen.

Ultrasound

Gas within the pelvicalyceal system may be evident as dirty shadowing on ultrasound.

CT

Gas-fluid level in dilated calyx, usually with mild or no obvious features of pyelonephritis.

Treatment and prognosis

Emphysematous pyelitis generally carries a good prognosis and usually responds to intravenous antibiotics followed by oral antibiotics .

Differential diagnosis

General considerations include:

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu emphysematöse Pyelonephritis:
Pyelonephritis
 
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akute
Pyelonephritis
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emphysematöse
Zystitis
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