Meteorism in emphysematous pyelonephritis: An unusual acute abdomen mimic

Emphysematous pyelonephritis is a potentially life-threatening necrotizing renal infection characterized by gas formation within the renal parenchyma and/or collecting system. Diabetes mellitus and urinary tract obstruction are important predisposing factors, while Escherichia coli and Klebsiella pneumoniae are frequently implicated pathogens. Although fever, flank pain, and vomiting are typical manifestations, gastrointestinal symptoms may occasionally dominate the presentation and mimic an acute surgical abdomen.