Emphysematous pyelonephritis: Clues to rapid diagnosis in the Emergency Department

Stone, Susan; Mallon, William K.; Childs, Jeanine M.; Docherty, Stephen

doi:10.1016/j.jemermed.2004.07.015

Cited by 27 publications

(17 citation statements)

References 15 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In several studies, sonography has been shown to be useful in assessing emphysematous cholecystitis, 12,13 emphysematous pyelonephritis, 14 and gas-producing soft tissue infections, 15,16 identifying either foreign bodies or the wound tract itself in penetrating trauma, 17,18 and identifying septicemia from gas-producing organisms. 19,20 Additionally, sonography has been shown to be a useful adjunct in assessing necrotizing fasciitis.…”

mentioning

confidence: 99%

Detection of Subcutaneous and Intramuscular Air With Sonography

Butcher

Dooley

Levitov

2011

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Detection of Subcutaneous and Intramuscular Air With Sonography

Butcher

Dooley

Levitov

2011

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

“…However, it is often readily available and very valuable in the hands of an experienced ultrasonographer. 4 CT is currently the preferred investigation for EPN, as it can delineate the extent of disease in addition to confirming the diagnosis. 5 Extensive renal parenchymal destruction has been shown to correlate with a need for nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous pyelonephritis masquerading as hollow viscus perforation

Malolan

Shivaswamy

Babu

et al. 2014

African Journal of Emergency Medicine

View full text Add to dashboard Cite

Introduction: Emphysematous pyelonephritis (EPN) may be defined as a severe infection of the kidney that leads to necrosis and the presence of gas in the renal parenchyma, surrounding tissue, and the pelvi-calyceal system. EPN occurs almost exclusively in diabetics, but may occasionally complicate obstructive uropathy in nondiabetic patients. Case Report: We present the case of a 45 year old male with uncontrolled diabetes mellitus who presented with acute abdominal pain and free intraperitoneal air on abdominal radiograph, initially suggestive of hollow viscus perforation. He was found to have EPN that had ruptured into the peritoneal cavity. Conclusion: Acute abdominal emergencies presenting with a pneumoperitoneum are not an uncommon occurrence in emergency centres throughout the world. However, rarely, patients present with the source of the pneumoperitoneum being an organ other than bowel. These patients need to be identified as soon as possible to prevent further morbidity and mortality arising from a delay in diagnosis.Introduction: La pye´lone´phrite emphyse´mateuse (PNE) peut se de´finir comme une infection grave du rein, entrainant une ne´crose et la pre´sence de gaz dans le parenchyme re´nal, les tissus pe´rire´naux et le syste`me pelvis-calices re´naux. La PNE survient presque exclusivement chez les personnes diabe´tiques, mais peut parfois entrainer une complication de l'uropathie obstructive chez les patients non diabe´tiques. É tude de cas: Nous pre´sentons dans cet article le cas d'un homme de 45 ans souffrant de diabe`te sucre´non controˆle´consultant pour des douleurs abdominales aigue¨s et la pre´sence d'air libre intra-pe´ritone´al apparaissant a`la radiographie abdominale, sugge´rant dans un premier temps une perforation des visce`res creux. Il souffrait en re´alite´d'une PNE avec rupture dans la cavite´pe´ritone´ale. Conclusion: Les urgences abdominales aigue¨s associe´es a`un pneumope´ritoine ne constituent pas un cas rare dans les centres d'urgences du monde entier. Cependant, il est rare que la source du pneumope´ritoine soit un organe autre que l'intestin chez les patients se pre´sentant. Ces patients doivent eˆtre identifie´s le plus rapidement possible afin d'e´viter une morbidite´et une mortalite´supple´mentaires associe´es a`un retard de diagnostic. African relevanceEmphysematous pyelonephritis is a very rare and late presentation of a common disease. It presents late due to lack of access to healthcare and poor patient education. It is more common in immunocompromised and diabetic patients with greater mortality and morbidity.

show abstract

“…It is more commonly seen in females (72-75%) than in males (25-28%), and the left kidney (52-60%) is more commonly involved than the right (35-43%); 96% of cases are associated with diabetes mellitus (1)(2)(3)(4).…”

Section: Case Reportmentioning

confidence: 99%