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Case Reports
. 2022 Oct 17;14(10):e30401.
doi: 10.7759/cureus.30401. eCollection 2022 Oct.

Emphysematous Cystitis Complicated by Pneumorrhachis

Jane Ehret  1 , Thomas W Powell  2 , Pang Lam  2 , Valerie Cluzet  3
Affiliations
Case Reports

Emphysematous Cystitis Complicated by Pneumorrhachis

Jane Ehret et al. Cureus. .

Abstract

Emphysematous cystitis (EC) is a potentially life-threatening urinary tract infection (UTI) characterized by the presence of gas within the bladder wall and lumen. The extension of gas beyond the bladder wall is rare and indicative of severe disease. We present a case of septic shock secondary to EC with the extension of air through the paraspinal and psoas muscles and into the epidural space of the lumbar spinal canal. This finding of intraspinal air is a rare radiographic phenomenon known as pneumorrhachis (PR).

Keywords: academic radiology; complicated uti; critical care and hospital medicine; critical care and internal medicine education; emphysema cystitis; id critical care; intensive care medicine; pneumorrhachis; severe sepsis; trauma critical care.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Non-contrast CT of the abdomen and pelvis (axial section through the urinary bladder).
Diffuse emphysema throughout the bladder wall with surrounding stranding (arrow). CT: computed tomography
Figure 2
Figure 2. Non-contrast CT of the abdomen and pelvis (axial section through the lumbar spine).
Air bubbles within the epidural space of the lumbar spinal canal (arrow). CT: computed tomography
Figure 3
Figure 3. Non-contrast CT of the abdomen and pelvis (sagittal section).
Air bubbles extending from the paraspinal muscles into the epidural space of the lumbar spinal canal (arrows). CT: computed tomography
See this image and copyright information in PMC

References

    1. Emphysematous cystitis: a review of the literature. Amano M, Shimizu T. Intern Med. 2014;53:79–82. - PubMed
    1. Emphysematous cystitis: illustrative case report and review of the literature. Grupper M, Kravtsov A, Potasman I. Medicine (Baltimore) 2007;86:47–53. - PubMed
    1. Coexistence of emphysematous cystitis and bilateral emphysematous pyelonephritis: a case report and review of the literature. Chávez-Valencia V, Orizaga-de-La-Cruz C, Aguilar-Bixano O, Lagunas-Rangel FA. CEN Case Rep. 2020;9:313–317. - PMC - PubMed
    1. Concurrent emphysematous pyelonephritis (EPN) and emphysematous cystitis (EC) presenting with septic shock. Syed S, Alrifai T. BMJ Case Rep. 2019;12 - PMC - PubMed
    1. Pathogenesis, diagnosis and management of pneumorrhachis. Oertel MF, Korinth MC, Reinges MH, Krings T, Terbeck S, Gilsbach JM. Eur Spine J. 2006;15 Suppl 5:636–643. - PMC - PubMed

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