PMC6745128_01
Axial noncontrast CT scan of the abdomen showing air (arrows) in the left renal parenchyma.
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A 64-slice detector computerized tomography (CT) scan without intravenous contrast with approximately CTVI 10 mGy dose of radiation was performed which revealed extensive left perinephric fat stranding with gas extending from the left renal parenchyma, perinephric fat, left ureter, and into the bladder (Figure 1) revealing the diagnosis of emphysematous pyelonephritis.
Longitudinal ultrasonography of the left kidney showing a- lines (arrows), indicating free air in the renal parenchyma.
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The left kidney showed reverberation artifacts (white arrows), caused by air in the renal pelvis (Figure 2).
Transverse ultrasound of the bladder showing reverberation artifacts (triangles) in the dirty shadow cast by the tissue-gas interface in the urinary bladder.
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Subsequent scanning of the urinary bladder showed a fluid-gas interface in the left upper quadrant of the bladder image (Figure 3), also demonstrated reverberation artifact (triangular pointers).