Fig. 8
Three days after PCNL treatment, a 40-year-old female underwent contrast-enhanced MDCT because of septic fever. Unenhanced (A) and contrast-enhanced (B, C) images showed left-sided pelvicalyceal dilatation with inflammatory-type stranding of the surrounding fat (*), mild enhancing urothelial thickening (thin arrow in B), ipsilateral fascial effusion (arrows) and decreased nephrographic parenchymal enhancement compared to the contralateral kidney (C). Hydronephrosis was due to small residual stone fragments in the lumbar ureter (not shown). Clinical and imaging suspicion of pyonephrosis was confirmed and relieved by positioning of the ureteral stent plus intensive antibiotic therapy