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OBJECTIVE The propose of this study was to describe the imaging findings in four patients with emphysematous pyelonephritis and to perform a review of the literature. METHODS Four cases of emphysematous pyelonephritis are presented. US and CT examinations were available for all patients. RESULTS Gas within the kidney may be diagnosed by plain film or rarely by ultrasound, but its location and its extent are best evaluated by CT. A review of the literature shows that emphysematous pyelonephritis is a rare and life-threatening infection typically occurring in diabetic patients. CONCLUSIONS CT is useful for diagnosing emphysematous pyelonephritis, especially when symptoms fail to resolve promptly with medical therapy.
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