Mamad Ayoub, Zerda Ilyass, Bibat Mohammed Amine, El Msaadi Siham, Messaoud Ola, Elkhader Khalid
Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
Int J Surg Case Rep. 2025 Jul;132:111458. doi: 10.1016/j.ijscr.2025.111458. Epub 2025 May 22.
Emphysematous cystitis (EC) is a rare anaerobic bacterial infection, often linked to diabetes, neurogenic bladder, or radiotherapy. Severe cases can weaken the bladder wall, causing spontaneous rupture, which may be intra- or extraperitoneal. While conservative treatment with drainage and antibiotics is possible, intraperitoneal rupture requires surgery to prevent septic shock.
A 61-year-old dialysis-dependent patient with a history of lumbotomy for renal calculus and type 2 diabetes was admitted for confusional syndrome and shock. Workup showed inflammatory syndrome, renal failure, and purulent urine. Imaging revealed EC with a retro vesical abscess and suspected bladder rupture. Surgical exploration confirmed spontaneous intraperitoneal bladder rupture with necrosis. Debridement, bladder suturing, cystostomy, and drainage were performed.
EC is a rare bladder infection characterized by gas accumulation, primarily associated with diabetes. It is caused by facultative anaerobes such as E. coli and Klebsiella pneumoniae. EC can range from asymptomatic to severe, potentially leading to spontaneous intra- or extraperitoneal bladder rupture, a rare but life-threatening complication. CT scans are the gold standard for diagnosis. Treatment of uncomplicated EC includes broad-spectrum antibiotics, bladder drainage, and glycemic control. Severe cases, especially intraperitoneal rupture, may require surgical intervention.
EC is a rare but severe bladder infection with a misleading presentation, which can delay diagnosis. If left untreated, it may lead to life-threatening complications such as bladder rupture and septic shock, requiring immediate surgical intervention. Our goal is to identify key diagnostic features that facilitate the early detection and effective management of emphysematous cystitis, preventing severe complications.
气肿性膀胱炎（EC）是一种罕见的厌氧菌感染，常与糖尿病、神经源性膀胱或放疗有关。严重病例可使膀胱壁变薄，导致自发性破裂，可能为腹膜内或腹膜外破裂。虽然可以采用引流和抗生素进行保守治疗，但腹膜内破裂需要手术以防止感染性休克。
一名61岁依赖透析的患者，有因肾结石行腰椎切开术病史及2型糖尿病，因意识模糊综合征和休克入院。检查显示有炎症综合征、肾衰竭和脓性尿液。影像学检查发现气肿性膀胱炎合并膀胱后脓肿及疑似膀胱破裂。手术探查证实为自发性腹膜内膀胱破裂伴坏死。进行了清创、膀胱缝合、膀胱造瘘和引流。
气肿性膀胱炎是一种罕见的膀胱感染，其特征为气体积聚，主要与糖尿病相关。它由兼性厌氧菌如大肠杆菌和肺炎克雷伯菌引起。气肿性膀胱炎可从无症状到严重，可能导致自发性腹膜内或腹膜外膀胱破裂，这是一种罕见但危及生命的并发症。CT扫描是诊断的金标准。单纯性气肿性膀胱炎的治疗包括广谱抗生素、膀胱引流和血糖控制。严重病例，尤其是腹膜内破裂，可能需要手术干预。
气肿性膀胱炎是一种罕见但严重的膀胱感染，表现具有误导性，可能延迟诊断。如果不治疗，可能导致危及生命的并发症，如膀胱破裂和感染性休克，需要立即进行手术干预。我们的目标是确定有助于早期发现和有效管理气肿性膀胱炎的关键诊断特征，预防严重并发症。
