Coronal CT– Emphysematous Pyelonephritis

Emphysematous pyelonephritis (EPN) is a severe, necrotizing infection of the kidney that is characterized by the presence of gas within the renal parenchyma, collecting system, or perinephric tissues. It is typically associated with urinary tract infections, most commonly caused by bacteria such as Escherichia coli. The condition is more common in individuals with diabetes mellitus, urinary tract obstruction, or other conditions that compromise the immune system.

EPN is a medical emergency, and prompt diagnosis and treatment are essential. The presence of gas within the kidney can be visualized on imaging studies such as CT scans. The infection can spread rapidly and may lead to serious complications, including sepsis and organ failure.

Treatment usually involves a combination of antibiotics and surgical intervention. Antibiotics are administered to control the infection, and surgery may be necessary to drain the infected fluid and remove necrotic tissue. In some cases, a nephrectomy) may be required.

Due to the severity of emphysematous pyelonephritis, close monitoring in an intensive care setting may be necessary. The choice of antibiotics is guided by the culture and sensitivity results, and adjustments may be made based on the patient’s response to treatment.

Coronal CT with Contrast– Emphysematous Pyelonephritis

Axial CT Non Contrast– Emphysematous Pyelonephritis

Axial CT with  Contrast– Emphysematous Pyelonephritis

A Second Patient