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Emphysematous cystitis

Case contributed by Augusto César Vieira Teixeira
Diagnosis certain

Presentation

Diabetic woman with non-specific abdominal pain and a palpable mass at the lower abdomen.

Patient Data

Age: 55 years
Gender: Female
x-ray

Abdominal plain radiograph obtained with the patient upright demonstrates gas within the bladder lumen and increased radiolucency representing air in the expected location of the urinary bladder with a few locules suggesting gas within its wall.

ct

CT demonstrates gas within the lumen and the wall of the bladder.

Case Discussion

Emphysematous cystitis represents a rare form of acute inflammation of the bladder mucosa and underlying musculature. Clinical symptoms of dysuria, increased urinary frequency, and hema­turia are common. The presence of pneumaturia is a rare, although more specific, clinical finding. Underlying diabetes mellitus is present in over half of reported cases, with women being affected twice as often as men.

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