Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-prod...Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.展开更多
BACKGROUND Emphysematous cystitis(EC)is a bladder condition commonly caused by gasgenerating bacterial infections.Factors that increase the risk for developing this condition include female gender,age≥60 years,and di...BACKGROUND Emphysematous cystitis(EC)is a bladder condition commonly caused by gasgenerating bacterial infections.Factors that increase the risk for developing this condition include female gender,age≥60 years,and diabetes mellitus,glycosuria,and urinary stasis.The symptoms of EC often lack specificity,making diagnostic imaging techniques crucial for accurate identification of the condition.CASE SUMMARY This report presents an unusual case of EC that mimicked intestinal perforation.While it was initially challenging to differentiate between intestinal perforation and EC on admission,the patient managed to avoid unnecessary surgery and made a good recovery solely through antibiotic treatment.CONCLUSION Successful treatment of the patient described herein highlights the importance of accurately diagnosing EC,which can be difficult to differentiate from intestinal perforation.展开更多
BACKGROUND Portal venous gas(PVG)is a rare clinical condition usually indicative of severe disorders,including necrotizing enterocolitis,bowel ischemia,or bowel wall rupture/infarction.Pneumatosis intestinalis(PI)is a...BACKGROUND Portal venous gas(PVG)is a rare clinical condition usually indicative of severe disorders,including necrotizing enterocolitis,bowel ischemia,or bowel wall rupture/infarction.Pneumatosis intestinalis(PI)is a rare illness characterized by an infiltration of gas into the intestinal wall.Emphysematous cystitis(EC)is relatively rare and characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging.Our study reports a rare case coexistence of PVG presenting with PI and EC.CASE SUMMARY An 86-year-old woman was admitted to the emergency room due to the progressive aggravation of pain because of abdominal fullness and distention,complicated with vomiting and stopping defecation for 4 d.The abdominal computed tomography(CT)plain scan indicated intestinal obstruction with ischemia changes,gas in the portal vein,left renal artery,superior mesenteric artery,superior mesenteric vein,some branch vessels,and bladder pneumatosis with air-fluid levels.Emergency surgery was conducted on the patient.Ischemic necrosis was found in the small intestine approximately 110 cm below the Treitz ligament and in the ileocecal junction and ascending colon canals.This included excision of the necrotic small intestine and right colon,fistulation of the proximal small intestine,and distal closure of the transverse colon.Subsequently,the patient displayed postoperative short bowel syndrome but had a good recovery.She received intravenous fluid infusion and enteral nutrition maintenance every other day after discharge from the community hospital.CONCLUSION Emergency surgery should be performed when CT shows signs of PVG with PI and EC along with a clinical situation strongly suggestive of bowel ischemia.展开更多
BACKGROUND Systemic emphysematous infection caused by Klebsiella pneumoniae(K.pneumoniae)is a rare but severe infection which can be lethal if the diagnosis is delayed.CASE SUMMARY We report a rare case of systemic em...BACKGROUND Systemic emphysematous infection caused by Klebsiella pneumoniae(K.pneumoniae)is a rare but severe infection which can be lethal if the diagnosis is delayed.CASE SUMMARY We report a rare case of systemic emphysematous infection via hematogenous dissemination from a liver abscess caused by K.pneumoniae,complicated by multiple organ dysfunction syndrome,septic shock,bacteremia,emphysematous cystitis,prostate and left seminal vesicle abscesses in a diabetic patient.The patient simultaneously presented with spontaneous pneumoperitoneum secondary to rupture of the emphysematous liver abscess.His condition after admission deteriorated rapidly and he died within a short period.This disease is a great challenge for the clinician as K.pneumoniae can cause multifocal emphysematous infections and fulminant septic shock.Pneumoperitoneum following spontaneous rupture of the liver abscess can result in intra-abdominal sepsis that further increases mortality rate.Moreover,appropriate site-specific intervention and adequate drainage of numerous emphysematous liver lesions are difficult.CONCLUSION Early diagnosis followed by efficient antibiotic therapy and surgical management are essential for systemic emphysematous infection.展开更多
文摘Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.
基金Supported by a research grant from Jeju National University Hospital in 2019,No.2019-30.
文摘BACKGROUND Emphysematous cystitis(EC)is a bladder condition commonly caused by gasgenerating bacterial infections.Factors that increase the risk for developing this condition include female gender,age≥60 years,and diabetes mellitus,glycosuria,and urinary stasis.The symptoms of EC often lack specificity,making diagnostic imaging techniques crucial for accurate identification of the condition.CASE SUMMARY This report presents an unusual case of EC that mimicked intestinal perforation.While it was initially challenging to differentiate between intestinal perforation and EC on admission,the patient managed to avoid unnecessary surgery and made a good recovery solely through antibiotic treatment.CONCLUSION Successful treatment of the patient described herein highlights the importance of accurately diagnosing EC,which can be difficult to differentiate from intestinal perforation.
文摘BACKGROUND Portal venous gas(PVG)is a rare clinical condition usually indicative of severe disorders,including necrotizing enterocolitis,bowel ischemia,or bowel wall rupture/infarction.Pneumatosis intestinalis(PI)is a rare illness characterized by an infiltration of gas into the intestinal wall.Emphysematous cystitis(EC)is relatively rare and characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging.Our study reports a rare case coexistence of PVG presenting with PI and EC.CASE SUMMARY An 86-year-old woman was admitted to the emergency room due to the progressive aggravation of pain because of abdominal fullness and distention,complicated with vomiting and stopping defecation for 4 d.The abdominal computed tomography(CT)plain scan indicated intestinal obstruction with ischemia changes,gas in the portal vein,left renal artery,superior mesenteric artery,superior mesenteric vein,some branch vessels,and bladder pneumatosis with air-fluid levels.Emergency surgery was conducted on the patient.Ischemic necrosis was found in the small intestine approximately 110 cm below the Treitz ligament and in the ileocecal junction and ascending colon canals.This included excision of the necrotic small intestine and right colon,fistulation of the proximal small intestine,and distal closure of the transverse colon.Subsequently,the patient displayed postoperative short bowel syndrome but had a good recovery.She received intravenous fluid infusion and enteral nutrition maintenance every other day after discharge from the community hospital.CONCLUSION Emergency surgery should be performed when CT shows signs of PVG with PI and EC along with a clinical situation strongly suggestive of bowel ischemia.
基金Supported by the National Natural Science Foundation of ChinaNo. 81560480+5 种基金Health Science Research Program of Gansu ProvinceNo. GSWSKY 2016-19Ph.D. Science Research Foundation of Lanzhou University Second HospitalNo. ynbskyjj 2015-1-09Cuiying Scientific and Technological Innovation Program of Lanzhou University Second HospitalNo. CY 2018-MS13
文摘BACKGROUND Systemic emphysematous infection caused by Klebsiella pneumoniae(K.pneumoniae)is a rare but severe infection which can be lethal if the diagnosis is delayed.CASE SUMMARY We report a rare case of systemic emphysematous infection via hematogenous dissemination from a liver abscess caused by K.pneumoniae,complicated by multiple organ dysfunction syndrome,septic shock,bacteremia,emphysematous cystitis,prostate and left seminal vesicle abscesses in a diabetic patient.The patient simultaneously presented with spontaneous pneumoperitoneum secondary to rupture of the emphysematous liver abscess.His condition after admission deteriorated rapidly and he died within a short period.This disease is a great challenge for the clinician as K.pneumoniae can cause multifocal emphysematous infections and fulminant septic shock.Pneumoperitoneum following spontaneous rupture of the liver abscess can result in intra-abdominal sepsis that further increases mortality rate.Moreover,appropriate site-specific intervention and adequate drainage of numerous emphysematous liver lesions are difficult.CONCLUSION Early diagnosis followed by efficient antibiotic therapy and surgical management are essential for systemic emphysematous infection.
