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Case Reports
. 2018 Jun 6:2018:4948375.
doi: 10.1155/2018/4948375. eCollection 2018.

Acute Diffuse Peritonitis Caused by Urinary Retention: A Rare Case of Gangrenous Cystitis

Konstantinos Kotoulas  1 , Chrysostomos Georgellis  1 , Engkin Kigitzi  1 , Apostolos Liappis  1 , Marios Spounos  1 , Vasiliki Tsalkidou  1 , Emmanouil Patris  1
Affiliations
Case Reports

Acute Diffuse Peritonitis Caused by Urinary Retention: A Rare Case of Gangrenous Cystitis

Konstantinos Kotoulas et al. Case Rep Urol. .

Abstract

Gangrenous cystitis is an umbrella term encompassing conditions from necrosis of the mucosa and submucosa to necrosis of the entire bladder wall that can result in acute peritonitis. Timely diagnosis is challenging as the symptoms are nonspecific and resemble other conditions such as cystitis. We report a case of gangrenous cystitis in a 63-year-old woman who was diagnosed with peritonitis preoperatively by a CT scan of the abdomen. Overdistension of the bladder due to chronic urinary retention was the primary cause. The patient underwent partial cystectomy, excising nonviable detrusor with preservation of the trigone and ureters, but conclusively succumbed. Etiopathology, symptoms, and treatment of this rare disease are also considered.

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Figures

Figure 1
Figure 1
Abdominal CT scan images revealing the presence of gas within the anterior bladder wall and retropubic space. The anterior bladder wall is not enhanced by contrast material.
Figure 2
Figure 2
Coronal/sagittal abdominal CT scan images suggesting bladder rupture and diffuse peritonitis.
Figure 3
Figure 3
CT cystography revealed extravasation of contrast solution in the peritoneal cavity.
Figure 4
Figure 4
Extensive necrosis of perivesical fat (arrow) and presence of pus in the retropubic space.
Figure 5
Figure 5
Preservation of both ureters and trigone (arrow) after debridement of the necrotic tissue.
Figure 6
Figure 6
Closure of the bladder using the viable tissue from the posterior wall and trigone.
See this image and copyright information in PMC

References

    1. Ballas K., Rafailidis S., Pavlidis T., et al. Gangrenous cystitis. International Urogynecology Journal. 2007;18(12):1507–1509. doi: 10.1007/s00192-007-0430-9. - DOI - PubMed
    1. Sataa S., Habiba M., Emna M. Urinary peritonitis caused by gangrenous cystitis. La Tunisie Médicale. 2013;91(12):736–737. - PubMed
    1. Daneshgari F., Liu G., Birder L., Hanna-Mitchell A. T., Chacko S. Diabetic bladder dysfunction: current translational knowledge. The Journal of Urology. 2009;182(6):S18–S26. doi: 10.1016/j.juro.2009.08.070. - DOI - PMC - PubMed
    1. Xiao N., Wang Z., Huang Y., Daneshgari F., Liu G. Roles of polyuria and hyperglycemia in bladder dysfunction in diabetes. The Journal of Urology. 2013;189(3):1130–1136. doi: 10.1016/j.juro.2012.08.222. - DOI - PMC - PubMed
    1. Christ G. J., Hsieh Y., Zhao W., et al. Effects of streptozotocin-induced diabetes on bladder and erectile (dys)function in the same rat in vivo. BJU International. 2006;97(5):1076–1082. doi: 10.1111/j.1464-410X.2006.06058.x. - DOI - PubMed

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