The roentgen aspects of necrotizing renal papillitis.

Acute necrosis of the renal papillae occurs most frequently as a complication in patients with diabetes mellitus and acute pyelonephritis (11, 12, 13). Less frequently it complicates the clinical picture of obstructive uropathy with super-imposed infection (10, 16, 17, 20). Because of the urgent measures necessary for treatment of papillary necrosis, it behooves the radiologist, as a consultant, to be aware of the clinical and laboratory findings as well as of the diverse Pyelographie changes that may take place. This paper includes a review of the roentgen observations recorded in the literature and a presentation of 8 cases of our own in which pyelography was performed. Acute necrosis of the renal papillae is known by a number of names: “necrotizing renal papillitis,” “renal papillary necrosis,” “renal medullary necrosis,” “necrotizing papillitis renis,” and “Gunther's necrosis,” among others. Necrosis of the renal papillae was first reported by von Friedreich in 1877 (40). He described varying stages o...