Left Flank Pain

57-year-old patient presented with left flank pain.

Figure 1. Left perinephric abscess with air fluid level.

Figure 2. Heterogeneous enhancing left renal parenchyma with perinephric space air.

Figure 3. Heterogeneous enhancing left renal parenchyma with perinephric space air.

Figure 4. Heterogeneous enhancing left renal parenchyma with perinephric space air.

Figure 5. B/L mild pleural effusion.

Diagnosis: Emphysematous pyelonephritis

CT scan showed heterogeneous enhancement of left kidney with air in renal tissue and perinephric space along with abscess in perinephric space. 

CT is the best diagnostic modality for emphysematous pyelonephritis.

CT features of emphysematous pyelonephritis differentiate into two types.

In addition, the Huang-Tseng CT classification system is also described.

Emphysematous pyelonephritis (EPN) is a morbid infection of kidneys with characteristic gas formation within or around the kidneys.

Severe cases often warrant a nephrectomy.