{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T14:15:18Z","timestamp":1778163318055,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Shenzhen Clinical Research Center for Urology and Nephrology","award":["LCYSSQ20220823091403008"],"award-info":[{"award-number":["LCYSSQ20220823091403008"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Emphysematous pyelonephritis is a rare, life-threatening necrotizing infection that is typically characterized by classic urinary symptoms. However, it is exceptionally rare for emphysematous pyelonephritis to manifest with predominant gastrointestinal symptoms, a deceptive mimicry that often masks the underlying renal pathology and leads to significant diagnostic delays. We report the case of a woman in her 60s with type 2 diabetes whose initial presentation was limited to vomiting and diarrhea, suggesting acute gastroenteritis. In the absence of typical urological distress, her condition rapidly worsened, and she developed septic shock and altered mental status within 48\u2009h. Computed tomography confirmed Huang\u2013Tseng class 3B emphysematous pyelonephritis with extensive destruction of the right renal parenchyma. Recognizing the irreversible tissue necrosis and failure of medical therapy, a decisive transition to emergency nephrectomy was performed. This timely surgical intervention successfully arrested the fulminant progression, leading to hemodynamic stabilization and recovery. This case underscores that emphysematous pyelonephritis rarely masquerades as gastroenteritis; in diabetic patients, such atypical manifestations followed by rapid clinical deterioration necessitate immediate computed tomography evaluation. Furthermore, when imaging reveals extensive gas formation and clinical stability is lost, prompt and resolute surgical source control is a critical, life-saving measure for ensuring patient survival.<\/jats:p>","DOI":"10.1177\/03000605261444872","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:43:44Z","timestamp":1777945424000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency nephrectomy for fulminant emphysematous pyelonephritis mimicking gastroenteritis: A case report"],"prefix":"10.1177","volume":"54","author":[{"given":"Wenhao","family":"Chu","sequence":"first","affiliation":[{"name":"Peking University Shenzhen Hospital"},{"name":"Peking University Shenzhen Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanqun","family":"Wang","sequence":"additional","affiliation":[{"name":"Peking University Shenzhen Hospital"},{"name":"Peking University Shenzhen Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songbai","family":"Yan","sequence":"additional","affiliation":[{"name":"Peking University Shenzhen Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiale","family":"Deng","sequence":"additional","affiliation":[{"name":"Peking University Shenzhen Hospital"},{"name":"Shenshan Hospital of Peking University Shenzhen Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengying","family":"Liao","sequence":"additional","affiliation":[{"name":"Peking University Shenzhen Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liangkuan","family":"Bi","sequence":"additional","affiliation":[{"name":"Peking University Shenzhen Hospital"},{"name":"Peking University Shenzhen Hospital"},{"name":"Peking University Shenzhen Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0887-7539","authenticated-orcid":false,"given":"Xing","family":"Fu","sequence":"additional","affiliation":[{"name":"Peking University Shenzhen Hospital"},{"name":"Peking University Shenzhen Hospital"},{"name":"Peking University Shenzhen Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.09660.x"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.6.797"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.05.017"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/tcmj.tcmj_257_21"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-019-02220-3"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-022-03131-6"},{"key":"e_1_3_9_8_2","first-page":"228","article-title":"Clinical profile and successful outcomes of conservative and minimally invasive treatment of emphysematous pyelonephritis","volume":"71","author":"Karthikeyan VS","year":"2018","unstructured":"Karthikeyan VS, Manohar CMS, Mallya A, et\u00a0al. Clinical profile and successful outcomes of conservative and minimally invasive treatment of emphysematous pyelonephritis. 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