A nontraditional presentation and treatment for emphysematous cystitis

Abstract

Emphysematous cystitis (EC) is a bladder pathology typically resulting from gas-producing bacterial infections. Risk factors include female gender, age greater than 60, diabetes mellitus, glycosuria, and urinary stasis. If not addressed promptly, it can progress to critical conditions. Management depends on severity, ranging from conservative to surgical interventions. We present a unique case of EC in a patient who lacked the most common risk factors, and who experienced a spontaneous intraperitoneal bladder rupture. Additionally, we treated this presentation against what historically is suggested. Lastly, this is the first published incidence of a patient with both Parkinson's Disease and EC.

Keywords: Cystitis; Emphysematous; Management; Rupture.

Fig. 1

CT A/P with IV contrast. A: free air anterior to liver and stomach (denoted by red arrows). B (more superior): free air within the antero-superior aspect of the bladder wall (denoted by red arrow). C (more inferior): free air in the anterior bladder wall and lumen (denoted by red arrow), as well as free peritoneal air anterior to the bladder. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)