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1型糖尿病患者的气肿性膀胱炎——诊断困难

[Emphysematous cystitis in a patient with type-1diabetes mellitus - diagnostic difficulties].

作者信息

Hadzik-Błaszczyk Małgorzata, Zielonka Tadeusz M, Krupa Renata, Rusinowicz Tomasz, Życińska Katarzyna

机构信息

Katedra I Zakład Medycyny Rodzinnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska.

出版信息

Wiad Lek. 2018;71(7):1424-1428.

Abstract

A case report of 28 year old female with medical history of bed controlled type 1 diabetes mellitus complicated by autonomic neuropathy in the form of gastroparesis, suffered by emphysematous cystitis caused by Escherichia coli was described. Emphysematous cystitis is a rare urinary tract infection connected with the presence of gas in the bladder lumen or/and within the bladder wall, which occurs mainly in women, in older age, suffering from type 2 diabetes, complicated by microangiopathy, neuropathy, with urinary tract obstruction and weakness of immunity system. Diagnostic difficulties and the delay in correct diagnosis in described case were caused by the dominated complaint of the upper gastrointestinal tract and difficulties in interpretation of imaging methods, such as abdominal X-ray and ultrasound scan. Eventually the use of computed tomography allowed to achieved an accurate diagnosis and choose appropriate treatment. It is possible that this is the first case of emphysematous cystitis described in Poland.

摘要

本文描述了一例28岁女性病例,该患者有胰岛素泵控制的1型糖尿病病史,并发胃轻瘫形式的自主神经病变,因大肠杆菌感染患气肿性膀胱炎。气肿性膀胱炎是一种罕见的尿路感染,与膀胱腔内或/和膀胱壁内存在气体有关,主要发生于老年女性,患有2型糖尿病,并发微血管病变、神经病变,伴有尿路梗阻和免疫系统功能低下。该病例中,上消化道的主要症状以及腹部X线和超声扫描等影像学检查结果解读困难导致诊断困难和诊断延误。最终,计算机断层扫描得以实现准确诊断并选择合适的治疗方法。这可能是波兰描述的首例气肿性膀胱炎病例。

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