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Year : 2014  |  Volume : 2  |  Issue : 3  |  Page : 99-102

Emphysematous pyelonephritis: An unusual case of pneumoperitoneum and intra-abdominal wall abscess

Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Correspondence Address:
Praveen S Padasali
S/O - S G Padasali, Maitri Galli, Jamkhandi, D-Bagalkot, Karnataka - 587 301
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2320-3846.147033

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Emphysematous pyelonephritis (EPN) is a rare gas-producing life-threatening necrotizing bacterial infection that involves the renal parenchyma and the perirenal tissue. It is encountered primarily in patients with diabetes mellitus or ureteral obstruction associated with perinephric and intrarenal gas. Causative organisms are those normally found in the urinary and gastrointestinal tracts. Multiple gas-producing organisms were the cause of the free intraperitoneal and perinephric air however anaerobic bacteria have been demonstrated in only 1% of cases. We describe a case of EPN, which presented as an acute abdomen with pneumoperitoneum in a diabetic patient. On the exploration, no visceral pathology was found, but the patient had right intra-abdominal wall abscess. Subsequent exploration revealed right pyelonephritis. Thus, presenting an unusual presentation of EPN as pneumoperitoneum and intra-abdominal wall abscess.

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