Gas surrounding the urinary bladder in emphysematous cystitis

Yang, Zhenyu; Sheng, Chang

doi:10.1590/s1677-5538.ibju.2016.0555

Int. braz j urol.

2017

DOI: 10.1590/s1677-5538.ibju.2016.0555

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Gas surrounding the urinary bladder in emphysematous cystitis

Zhenyu Yang

Chang Sheng

Abstract: We report a rare case of emphysematous cystitis in a 66-year-old woman with a history of diabetes mellitus. The predisposition of diabetes mellitus and infection of gas-forming bacteria is considered to precede the manifestation of emphysematous cystitis. The present recommended diagnosis test is computed tomography, which have definite value in the evaluation of gas accumulation in bladder wall, or an air-fluid level in bladder.

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“…Recently, Yang et al ( 1 ) published the abdominal computed tomography (CT) images showing diffuse gas within the bladder wall and a prominent air-fluid level as the typical manifestation of emphysematous cystitis. However, it's not only involved in the bladder wall but also in the bladder lumen ( 2 , 3 ).…”

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Re: Gaseous bladder tamponade secondary to emphysematous cystitis

Chen

Juan

et al. 2018

Int. braz j urol.

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Recently, Yang et al.(1) published the abdominal computed tomography (CT) images showing diffuse gas within the bladder wall and a prominent air-fluid level as the typical manifestation of emphysematous cystitis. However, it's not only involved in the bladder wall but also in the bladder lumen (2, 3). We hereby present a case of gaseous bladder temponade causing obstructive uropathy -a rarely severe complication of emphysematous cystitis.Our patient is a 81-year-old man who presented to the emergency department with 2 days of history of fever, progressed low abdominal distention and decreased urine output. He had type 2 diabetes mellitus and flaccid neurogenic bladder with long-term indwelling Foley catheter for the preceding two years. Laboratory studies revealed bacteriuria, leukocytosis, an elevated C-reactive protein level, high fasting blood glucose (302mg/dL), and an elevated creatinine level (2.05mg/dL). Radiography of the kidneys, ureters, and bladder revealed a low density over the whole bladder area and linear collection of gas along bladder wall (Figure-1). Abdominal CT was subsequently arranged, which showed gas tamponade in the bladder with bilateral obstructive hydronephrosis (Figure-2). A new Foley catheter was changed, and bladder irrigation was performed to extract pus and gas. He was treated with broad-spectrum re: Gaseous bladder tamponade secondary to emphysematous cystitis _______________________________________________ antibiotics and strict blood sugar control. Both blood and urine cultures grew Klebsiella pneumonia. He responded with defervescence and recovery of renal function (creatinine=1.39mg/ dL) after a full course of antibiotics treatment.Emphysematous cystitis is an uncommon disease characterized by the presence of air within the bladder wall and lumen, and primarily observed in diabetic patients. In this

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Re: Gaseous bladder tamponade secondary to emphysematous cystitis

Chen

Juan

et al. 2018

Int. braz j urol.

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Emphysematous Cystitis: Report of Two Cases and Review of the Literature

Banga-Mouss,

Mbamognoua,

Nyanga

et al. 2024

Health

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Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.

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Gas surrounding the urinary bladder in emphysematous cystitis

Cited by 2 publications

References 5 publications

Re: Gaseous bladder tamponade secondary to emphysematous cystitis

Re: Gaseous bladder tamponade secondary to emphysematous cystitis

Emphysematous Cystitis: Report of Two Cases and Review of the Literature

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