Emphysematous abdominal infections are regarded as potentially life-threatening conditions and benefit from appropriate radiological imaging for timely diagnosis and treatment planning. A 70-year-old non-diabetic male presented with an acute abdomen and had computed tomography diagnosed emphysematous pancreatitis, cholecystitis, and pyelonephritis. Treatment included broad-spectrum antimicrobial therapy. Ultrasound-guided percutaneous drain placement into the peri-pancreatic collection permitted culture-directed antibiotic therapy and continued drainage of the purulent collection. He achieved non-operative management of the first reported case of simultaneous emphysematous infections of the pancreas, gallbladder, and urinary system. His imaging and non-operative management are described.
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