International Congress of Radiology, Al-Ghardaqah, Egypt, 15 - 17 March 2023, pp.111
Emphysematous Pyelonephritis Emphysematous pyelonephritis (EPN) is a life-threatening necrotizing infection with mortality as high as 70%. It consists of renal parenchyma and/or perinephric tissue necrosis. Likely due to the higher incidence of urinary tract infections, EPN is seen more commonly in females. The greatest risk factor for developing EPN is uncontrolled diabetes mellitus. USG shows non-dependent echoes within the parenchyma and collecting system with dirty shadowing. However, USG is not sensitive to small amounts of gas. CT is performed to evaluate the severity, ‘ extent of disease, parenchymal destruction, fluid collections, and abscess formation. It is divided into two forms depending on severity and prognosis. Type 1 is the more severe type with a mortality rate of 80%. Type 2 is less common and has a mortality rate of 20%.
Emphysematous pyelitis Emphysematous pyelitis is a term that represents a gas-related, gas-forming urinary tract infection located only in the renal collecting system. It should be clearly differentiated from the much more serious progressive emphysematous pyelonephritis, which is gas production from an infection in the renal parenchyma rather than just the collecting system. In addition, it is necessary to exclude iatrogenic causes of gas in the collecting system.
Emphysematous cystitis Although Emphysematous cystitis is a rare condition of bladder infection ıt ıs a serious urinary tract infection. Emphysematous cystitis occurs more frequently in female patients and those with diabetes. The most common pathogen is E. coli. Emphysematous cystitis is a radiographically identifiable disease. CT is a highly sensitive examination that allows the early detecti on of intraluminal or intramural gas. CT is also useful in explaining the cause and differential diagnosis of the emphysematous condition.