A case of emphysematous cystitis

Emphysematous cystitis is a rare lower urinary tract infection. Patients with diabetes mellitus, neurogenic bladder, and recurrent urinary tract infection are generally at higher risk of this disease. A 71-year-old woman with neurogenic bladder was referred from the internal medicine department because of urinary retention. Abdominal radiography and computed tomographic (CT) scanning revealed a characteristic accumulation of air in the wall and lumen of the urinary bladder. Emphysematous cystitis was improved by antibiotic therapy and urinary drainage. CT scan was a sensitive method for detecting early signs and confirming the diagnosis.     

A case of emphysematous cystitis

Emphysematous cystitis is a rare but interesting disease. A case is reported of cystitis emphysema with acute pyelonephritis and uncontrolled diabetes. The patient was a 54-year-old woman complaining of gross hematuria and fever. A submucosa emphysema in bladder was found by cystoscopy . Radiography showed the gas around the bladder. The patient was administered antibiotics, then symptoms was improved. We reviewed 12 cases of emphysematous cystitis reported in Japan and summarized the pathophysiologic features of this entity.     

A case of emphysematous pyelonephritis with emphysematous cystitis]

A 74-year-old woman with diabetes mellitus had a high fever, and was treated with antibiotics and insulin in another hospital. She was referred to our department, because CT scan showed the right hydronephrosis and the abnormal gas shadow in the right renal calyces. Ureteral catheterization was performed on the right side and cloudy urine was drained. Urine culture yielded E. coli. Since submucosal emphysematous changes were demonstrated in the bladder mucosa by cystoscopy, she was diagnosed with emphysematous pyelonephritis with emphysematous cystitis associated with diabetes mellitus. Administration of antibiotics and insulin and the ureteral catheter drainage improved her condition immediately. Abnormal gas shadow on CT scan and submucosal emphysema on cystoscopy disappeared. We reviewed 110 cases of emphysematous pyelonephritis and 23 cases of emphysematous cystitis including our case in Japan, and report their clinical characteristics.     

A case of emphysematous cystitis : a case report

Emphysematous cystitis is a rare lower urinary tract infection. A case of emphysematous cystitis with diabetes mellitus and transverse colon cancer is reported. The patient was an 81-year-old woman complaining of nausea and vomiting. Urinalysis showed hematopyuria. Plain abdominal film and CT scan showed gaseous shadow in the bladder wall. Urine culture contained Escherichia coli. A urethral catheterization and administration of antibiotics resulted in the marked improvement in the clinical course. To our knowledge, 53 cases of emphysematous cystitis have been reported in the Japanese literature including this case and the clinical features are reviewed.     

A case of emphysematous cystitis: a case report

A 86-year-old woman presented with asymptomatic gross hematuria,and visited our hospital, and a vesicorectal fistula was suspected from a computed tomographic (CT) scan. She had a lower abdominal mass and urinary retention on arrival. Pclvic CT demonstrated intramural gas in the urinary bladder,which suggested a diagnosis of emphysematous cystitis. Cystoscopy demonstrated reddish mucosa and gas within the bladder wall. The gross hematuria was improved and the intramural gas disappeared on a CT scan after urinary drainage and antibiotic therapy. Although emphysematous cystitis is almost always cured with conservative therapy, an accurate diagonosis and prompt treatment are required because rarely emphysematous cystitis can result in rupture of the urinary bladder and lead to septic shock.     

A case of emphysematous cystitis with familial amyloidosis

This is a report of the thirteenth known case in Japan of emphysematous cystitis. A 70-year-old man visited our hospital because of pollakisuria and macrohematuria on November 21, 1989. The patient had been known to have familiar amyloid polyneuropathy for the previous 3 years. Urinalysis showed marked hematopyuria. The residual urine was 216 cc, and urine cultures yielded 10,000,000 colonies of Escherichia coli per ml. Laboratory studies revealed systemic inflammatory findings, but no diabetic change. A plain X-ray film of the abdomen and an excretory urogram (DIP) showed small linear and round gas collections in the bladder shadow. A CT scan revealed multiple gas locules within the bladder wall. A diagnosis of emphysematous cystitis was established. The patient was given antibiotics, and there was striking clinical improvement. Histological examination of the endoscopically obtained biopsy specimen of the bladder revealed amyloidosis. We believe that this patient had a cystitis emphysematosa precipitated neurogenic bladder due to amyloid polyneuropathy and amyloidosis of the bladder.     

Three cases of emphysematous cystitis

Emphysematous cystitis is a rare form of acute cystitis presenting with gas collection in the bladder wall and lumen. We report three cases of emphysematous cystitis. The first patient was a 71-year-old woman with gross hematuria. Intravenous pyelography and cystoscopy revealed a characteristic gas collection in the bladder. The second patient was a 59-year-old man with abdominal fullness who was hospitalized for treatment of a cerebral infarction. Abdominal radiography and computed tomographic (CT) scan demonstrated emphysematous cystitis. The third patient was a 67-year-old man with diarrhea and abdominal pain after operation for rectal cancer. CT scan accidentally showed gas bubbles in the bladder wall and lumen. All of the cases, the symptoms were improved after treatment with antibiotics.     

膀胱软结石合并气肿性膀胱炎(附一例报告)

目的 认识膀胱软结石的发病机理与临床特点。方法 回顾性分析1例膀胱软结石病例，结合文献复习。患者男，53岁。有膀胱癌、糖尿病及良性前列腺增生伴尿潴留病史。KuB(一)，尿培养见大肠杆菌，B超及膀胱镜见膀胱内占位。结果 患者行手术治疗，术中见软结石，呈分层壳状结构，病理表现为纤维素样结构。术后给予抗生素治疗2周，痊愈出院。结论 膀胱软结石常继发于泌尿系感染和糖尿病，治疗以手术取石为主，结合敏感抗生素治疗。     

Intraperitoneal bladder perforation in emphysematous cystitis

Contribution of one case report of a 69-year old diabetic male patient with neurogenic bladder. The patient developed emphysematous cystitis and peritonitis secondary to intraperitoneal perforation of the bladder. Emphysematous cystitis is an uncommon clinico-radiologic entity more frequent in diabetic and female patients and the elderly. Early diagnosis and treatment may avoid a fatal outcome. The paper includes a review of this condition.     

A case report of emphysematous pyelonephritis

A 51-year-old male patient with diabetes mellitus consulted his home doctor because of high fever and right flank pain. Urinalysis showed marked pyuria. Treatment with antibiotics was not completely effective, and he was referred to our hospital for further examination and treatment. CT scan showed an abnormal gas shadow in right renal parenchyma. He was diagnosed with emphysematous pyelonephritis and right subcapsular nephrectomy was done after the control of diabetes mellitus. We reviewed 57 cases of emphysematous pyelonephritis including our case in the Japanese literature, and we discussed about its etiology, symptomatology, choice of treatment and prognosis.     

Suppurative emphysematous bulla. A case report

The authors present a case of infected emphysematous bulla. Surgical treatment is always indicated also when a preoperative sure diagnosis between this and other pulmonary infections is not possible. The surgical management is often simple, without serious postoperative complications.     

A case of lupus cystitis

A case of lupus cystitis in a 23-year-old male is reported. The patient began to complain of diarrhea and vomiting in October, 1985. When the diagnosis of systemic lupus erythematosus (SLE) was established at the Department of Internal Medicine in our hospital, he was referred to our clinic for examination of pollakisuria on November 22. DIP revealed a loss of bladder distensibility, and bilateral hydronephrosis and hydroureter. Transurethral cold cup biopsies revealed subcutaneous edema. A diagnosis of lupus cystitis was made and he was treated with steroids, which resulted in symptomatic and radiographic improvement.     

A case of eosinophilic cystitis

A 67-year-old man presented with pollakisuria, and miction pain. The patient who had superficial bladder cancer was treated with transurethral resection and instillation of Pirarubicin hydrochloride. Urinalysis revealed a marked increase in eosinophilic cells. A cystoscopic examination revealed an ischemic lesion and hypervascular lesion throughout the bladder. Histological findings of biopsied bladder specimens showed eosinophilic cystitis. Bladder symptoms are improved with steroid administration.     

A case of bullous cystitis

A case of bullous cystitis with a right ureter stone seen in a 25-year-old male is described. Inflammatory tumorous cystitis was performed. One month after transurethral resection, there was inflammatory tumorous cystitis at the same position. Therefore, right ureterolithotomy and right ureterovesical neostomy were done. The patient is currently in good health 1 year and 5 months after the surgery.     

A case of xanthogranulomatous cystitis

We report a case of xanthogranulomatous cystitis (XC) in a 76-year-old man who presented with painless hematuria and a bladder mass on imaging studies. Xanthogranuloma is a chronic inflammatory condition that most commonly involves the kidney. XC is a rare condition of still unknown aetiology with only about 20 cases reported to date. The gold standard treatment is surgical resection. Consideration should be given to this entity in the differential diagnosis of urinary bladder masses.