Extensive emphysematous pyelonephritis in association with hepatic portal venous gas and emphysematous gastritis: A rare case

Although emphysematous pyelonephritis is recognized from more than hundred years, the etiology is still controversial. Glucose fermentation is the proposed possible mechanism for gas fermentation. The extension of emphysematous pyelonephritis into portal vein and stomach is a rare condition. We present a 52-year-old woman with uncontrolled diabetes who was admitted with sepsis and left flank pain. She was investigated, and results revealed gas in the left renal system with extension into portal vein and stomach. She was resuscitated and managed with percutaneous drainage, DJ stenting, and broad spectrum antibiotics, she did not improve and hence nephrectomy was done. Prompt diagnosis, early and aggressive treatment is crucial because of high mortality