Case profile: Renal emphysema

URORADM3LOGY

(:ASE PROFILE:

RENAL

EMPHYSEMA

.A thirt!--tllr~~-)-ear-old man was born with sc’vcm1 collgr,nital malformations, including, among othclrs. Irl?.clolncningocele, esstrophy of the l~laddcl-. and al~scwcc of the penis. As it child he Ilndenl ent Materal ureterosigmoidostomy and hul)sequcutly progressivy renal insufficienq srcondq. to chronic bacterial pyelonephritis

ter, produced by several etiologic c~onditions. Fist&us tracts of the renal crcrctory s!,stem with the intestines or the skill cm lrwl to this entity. In addition, urinary tract infections with Flucose-ferliientilig organisu~s c’iu~ prodllctl iI similar picture, particularly in tliiibt~tics or in nondiabetic patients with preexisting lmderlying

developed. _I close-up of the plain film of the abdomrn (Fig. 1A) shows a “pneamop~clugram” in;is ;1 c’~)114e~~u~n(‘e of the iatrogenic’ally tl~~ct~l coml~lul~ic~ation between the ureter and the gas-containing sigmoid. After dye injection, .i tnarkedl!. dilated ureter and pyelocalyceal systern reproduced exactly the previous air-filled renal (aucretor)’ system (Fig. 1B). The terln renal emphysema has been used to tlescrilx the anomalous presence of gas within the collecting system: calyces, pelvis, ancl ure-

obstructive emphysema ries 3 gravr

pathology. The prt‘se~nc~~ of renal in the latter two group\ 11sual1y cxrprognosis. *’ JULII J. Oliv~ro, lkpartment

X1.D

.iyus, Xl. D. Juan Carlos of l\ledicinc, Renal ScTtiOll. Baylor College of Medicine

Houston.

‘Trxas 77030