Pneumomediastinum Secondary to Acute Emphysematous Pyelonephritis

Pneumomediastinum is a clinical and radiographic finding that is associated with a wide range of acute processes that allow gas to disseminate through the tissues of mediastinum that often necessitates prompt consideration for thoracic intervention. In some circumstances, pneumomediastinum may arise from processes extrinsic to the thoracic cavity and is a secondary process arising from a primary retropharyngeal or retroperitoneal etiology. Acute emphysematous pyelonephritis is a rare and severe infectious disease of the kidney associated with a very high mortality rate. We report a case of advanced emphysematous pyelonephritis presenting with pneumomediastinum successfully treated with simple nephrectomy in the absence of any direct mediastinal intervention.