Vol. 1, Issue 1, Part A (2019)

Introduction: Emphysematous pyelonephritis (EPN) is an uncommon acute severe necrotizing infection of the kidney. This study describes the management of patients with EPN who were admitted to a tertiary center in Doha, Qatar.

Methods: This retrospective case series included all admitted patients who were diagnosed clinically and radiologically with EPN over a 5-year period. Their clinical presentation, risk factors, and management plans were analyzed.

Results: Over the 5-year study period, 26 patients, including 11 men and 15 women, were diagnosed with EPN. Diabetes mellitus was the most frequent risk factor, and Escherichia coli was the most common pathogen. Conservative management was successful in nine patients. The other 17 patients required early drainage, either by percutaneous nephrostomy or ureteral stenting, with two patients undergoing elective nephrectomy after stabilization of their septic condition. None of these patients died.

Conclusion: EPN usually occurs in adults with poorly controlled type 2 diabetes mellitus and obstructive ureteral stones. Early diagnosis and management with a multidisciplinary approach and minimally invasive drainage procedures reduces patient morbidity and mortality.