An Atypical Case of Emphysematous Cystitis in a Young Non-Diabetic Patient

Charkhand, Behshad; Valeshabad, Ali Kord; Farahany, Joseph; Warncke, Jason; Hayrapetian, Artineh; Nehler, Mark R.; Wilson, Shandra

doi:10.14740/wjnu374

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…With a mortality rate of 7.4%, EC is a rare but critical condition[ 33 ]. It is commonly seen in elderly, diabetic females with an infective organism[ 33 ] and in immunocompromised people[ 34 - 36 ]. Very little information regarding emphysematous cystitis has been reported.…”

Section: Discussionmentioning

confidence: 99%

Portal vein gas combined with pneumatosis intestinalis and emphysematous cystitis: A case report and literature review

Hu¹,

Liu²,

Hao³

2022

WJCC

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BACKGROUND Portal venous gas (PVG) is a rare clinical condition usually indicative of severe disorders, including necrotizing enterocolitis, bowel ischemia, or bowel wall rupture/infarction. Pneumatosis intestinalis (PI) is a rare illness characterized by an infiltration of gas into the intestinal wall. Emphysematous cystitis (EC) is relatively rare and characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging. Our study reports a rare case coexistence of PVG presenting with PI and EC. CASE SUMMARY An 86-year-old woman was admitted to the emergency room due to the progressive aggravation of pain because of abdominal fullness and distention, complicated with vomiting and stopping defecation for 4 d. The abdominal computed tomography (CT) plain scan indicated intestinal obstruction with ischemia changes, gas in the portal vein, left renal artery, superior mesenteric artery, superior mesenteric vein, some branch vessels, and bladder pneumatosis with air-fluid levels. Emergency surgery was conducted on the patient. Ischemic necrosis was found in the small intestine approximately 110 cm below the Treitz ligament and in the ileocecal junction and ascending colon canals. This included excision of the necrotic small intestine and right colon, fistulation of the proximal small intestine, and distal closure of the transverse colon. Subsequently, the patient displayed postoperative short bowel syndrome but had a good recovery. She received intravenous fluid infusion and enteral nutrition maintenance every other day after discharge from the community hospital. CONCLUSION Emergency surgery should be performed when CT shows signs of PVG with PI and EC along with a clinical situation strongly suggestive of bowel ischemia.

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Section: Discussionmentioning

confidence: 99%

Portal vein gas combined with pneumatosis intestinalis and emphysematous cystitis: A case report and literature review

Hu¹,

Liu²,

Hao³

2022

WJCC

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Emphysematous cystitis: a cause of hematuria post angioplasty

Parker

Bouayyad

Tam

et al. 2020

Journal of Surgical Case Reports

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Emphysematous cystitis (EC) is a rare, severe, urinary tract infection caused by gas-producing bacteria. It is characterized by the accumulation of air inside the bladder wall and/or lumen and is common among elderly diabetic females. This case of a 90-year-old female, who underwent bilateral iliac angioplasty and stenting, is the first published correlation between iliac angioplasty and the development of EC. The endovascular procedure performed was a success, but later on, she was confused and developed frank haematuria with a fall in haemoglobin levels. CT revealed severe EC with abundant gas tracking outside of urinary bladder into the extraperitoneal space. She was catheterized and empirical antibiotics were started and converted based on the culture sensitivities. Frequent follow-up ensured the resolution of a conservatively managed case. It is essential to increase the awareness of EC associated with angioplasties among the healthcare staff, particularly those undertaking vascular procedures.

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An Atypical Case of Emphysematous Cystitis in a Young Non-Diabetic Patient

Cited by 2 publications

References 4 publications

Portal vein gas combined with pneumatosis intestinalis and emphysematous cystitis: A case report and literature review

Portal vein gas combined with pneumatosis intestinalis and emphysematous cystitis: A case report and literature review

Emphysematous cystitis: a cause of hematuria post angioplasty

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