Parker Sidney, Bouayyad Sarah, Tam Jonathan, Kansal Nisheeth, Bhattacharya Vish
Department of Urology, Queen Elizabeth Hospital, Gateshead, UK.
Department of Otolaryngology, Tameside General Hospital, Ashton-under-Lyne, UK.
J Surg Case Rep. 2020 Feb 19;2020(2):rjz401. doi: 10.1093/jscr/rjz401. eCollection 2020 Feb.
Emphysematous cystitis (EC) is a rare, severe, urinary tract infection caused by gas-producing bacteria. It is characterized by the accumulation of air inside the bladder wall and/or lumen and is common among elderly diabetic females. This case of a 90-year-old female, who underwent bilateral iliac angioplasty and stenting, is the first published correlation between iliac angioplasty and the development of EC. The endovascular procedure performed was a success, but later on, she was confused and developed frank haematuria with a fall in haemoglobin levels. CT revealed severe EC with abundant gas tracking outside of urinary bladder into the extraperitoneal space. She was catheterized and empirical antibiotics were started and converted based on the culture sensitivities. Frequent follow-up ensured the resolution of a conservatively managed case. It is essential to increase the awareness of EC associated with angioplasties among the healthcare staff, particularly those undertaking vascular procedures.
气肿性膀胱炎(EC)是一种由产气细菌引起的罕见、严重的尿路感染。其特征是膀胱壁和/或腔内积聚气体,在老年糖尿病女性中较为常见。本例90岁女性接受了双侧髂血管成形术和支架置入术,是髂血管成形术与EC发生之间首次发表的相关性病例。所进行的血管内手术很成功,但后来她出现意识模糊,并出现明显血尿,血红蛋白水平下降。CT显示严重的气肿性膀胱炎,大量气体从膀胱外蔓延至腹膜外间隙。对她进行了导尿,并开始使用经验性抗生素,之后根据培养药敏结果进行调整。频繁的随访确保了这例保守治疗病例的痊愈。提高医护人员,尤其是从事血管手术的人员对与血管成形术相关的气肿性膀胱炎的认识至关重要。