A Rare Case of Emphysematous Pyelonephritis, Mimicking Perforation Peritonitis in a Non-diabetic

A Rare Case of Emphysematous Pyelonephritis, Mimicking Perforation Peritonitis in a Non-diabetic

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Emphysematous Pyelonephritis (EPN) is rare, severe gas-forming infection of renal parenchyma and its surrounding areas.This is a rare case of EPN in a non-diabetic, middle aged man who presented to the emergency department with diffuse abdominal pain, tenderness, guarding and rigidity throughout the abdominal wall with acute urinary retention.Foley catheter and infant feeding tube did not pass, indicating the possibility of a stricture per urethrally.

An emergency suprapubic catheterisation was done.An erect abdomen radiograph swisse high strength magnesium powder berry was done which showed gas click here shadow in the left kidney and air foci on the right side.An urgent contrast CT scan was done which was suggestive of bowel perforation and interbowel fluid along with air foci in the left kidney, suggestive of EPN.

Patient was taken for an emergency exploratory laparotomy.EPN is indeed rare entity presenting clinically as perforation peritonitis.So, the surgeon should adapt an aggressive approach in treating this condition and an early nephrectomy should not be delayed.