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A CT scan obtained before laparotomy was undertaken, showing gas destroying the left renal parenchyma with extension into the pararenal space and rupture through the posterior parietal peritoneum with an intact gastrointestinal tract. Laparotomy was thus avoided; pneumoperitoneum is not always gastrointestinal in origin.<\/jats:p>","DOI":"10.1177\/00494755261502702","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:42:07Z","timestamp":1792816927000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["When the abdomen misleads: Emphysematous pyelonephritis masquerading as pneumoperitoneum"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6741-2842","authenticated-orcid":false,"given":"Neel","family":"Swaminarayan","sequence":"first","affiliation":[{"name":"Dr Baba Saheb Ambedkar Medical College and Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devesh","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Dr Baba Saheb Ambedkar Medical College and Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9305-3704","authenticated-orcid":false,"given":"Mohammad Shazib","family":"Faridi","sequence":"additional","affiliation":[{"name":"Dr Baba Saheb Ambedkar Medical College and Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kartik","family":"Sridhar","sequence":"additional","affiliation":[{"name":"Dr Baba Saheb Ambedkar Medical College and Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulqadir","family":"Boringwala","sequence":"additional","affiliation":[{"name":"Dr Baba Saheb Ambedkar Medical College and Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Garg","sequence":"additional","affiliation":[{"name":"Dr Baba Saheb Ambedkar Medical College and Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.6.797"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.09660.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1626-1-91"},{"key":"e_1_3_2_5_2","first-page":"6","article-title":"Emphysematous pyelonephritis presenting as pneumoperitoneum","volume":"5","author":"Aggarwal D","year":"2016","unstructured":"Aggarwal D, Jain SK, Singh CB, et\u00a0al. Emphysematous pyelonephritis presenting as pneumoperitoneum. 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