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Updated: Oct 23, 2025

Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
Concurrent bilateral emphysematous pyelonephritis and secondary iliopsoas abscess extending to thigh muscles with
Diaa-Eldin Taha1, Ali Abdel Raheem2, Abdulhkam Aljarbou3
1Urology Department, King Saud Medical City, Riyadh, Saudi Arabia; Urology department, Kafrelsheikh University, Egypt.
Introduction:
Bilateral emphysematous pyelonephritis is exceedingly rare.
Case Presentation:
A 56 year old diabetic male presented with high grade fever 40o c, chills, and bilateral loin pain since two weeks a picture of septic shock. CT showed bilateral emphysematous pyelonephritis, the left kidney was smaller in size, the right renal unit showed marked hydronephrosis, right iliopsoas abscess extending to the thigh. The patient was managed by bilateral nephrostomy tubes and two retroperitoneal drains. Initially, the patient recovered, but the general condition deteriorated and profuse rectal bleeding occurred. Colonoscopy showed bleeding colonic mucosa.
Conclusion:
Bilateral emphysematous pyelonephritis is devastating disease that should be managed promptly to avoid septic shock.
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