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PICTURES IN CLINICAL MEDICINE
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An Unusual Cause of Hematuria: Emphysematous Cystitis Yoshiro Hadano Key words: emphysematous cystitis, hematuria (Intern Med 54: 1681, 2015) (DOI: 10.2169/internalmedicine.54.4468)
Picture 2.
Picture 1.
An 83-year-old Japanese woman with diabetes visited our clinic for the treatment of macroscopic hematuria. Her vital signs were stable, including her temperature. Her abdomen was soft, with mild tenderness in the lower region, and a plain X-ray of the abdomen showed a non-specific gas pattern with moderate collection of air in the shape of the bladder (Picture 1). In addition, a computed tomographic scan of the pelvis revealed the diffuse collection of gas in the wall of the urinary bladder (Picture 2). Emphysematous cystitis is a relatively rare complication of lower urinary tract infection (1). Abdominal pain is reported in 80% of cases, with hematuria in 47.6% cases and fever in 47.6% cases. Abdominal radiography is extremely sensitive (97.4%), although computed tomography is the
most sensitive and specific tool for diagnosis (2). It is important to keep in mind that emphysematous cystitis can be a rare cause of hematuria and may occur in the elderly and/ or diabetic patients. The author states that he has no Conflict of Interest (COI).
References 1. Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphysematous cystitis: a review of 135 cases. BJU Int 100: 17-20, 2007. 2. Grupper M, Kravtsov A, Potasman I. Emphysematous cystitis: illustrative case report and review of the literature. Medicine (Baltimore) 86: 47-53, 2007.
Department of Clinical Tropical Medicine, Mahidol University, Thailand Received for publication November 10, 2014; Accepted for publication November 30, 2014 Correspondence to Dr. Yoshiro Hadano, [email protected] Ⓒ 2015 The Japanese Society of Internal Medicine Journal Website: http://www.naika.or.jp/imonline/index.html
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PICTURES IN CLINICAL MEDICINE
□
An Unusual Cause of Hematuria: Emphysematous Cystitis Yoshiro Hadano Key words: emphysematous cystitis, hematuria (Intern Med 54: 1681, 2015) (DOI: 10.2169/internalmedicine.54.4468)
Picture 2.
Picture 1.
An 83-year-old Japanese woman with diabetes visited our clinic for the treatment of macroscopic hematuria. Her vital signs were stable, including her temperature. Her abdomen was soft, with mild tenderness in the lower region, and a plain X-ray of the abdomen showed a non-specific gas pattern with moderate collection of air in the shape of the bladder (Picture 1). In addition, a computed tomographic scan of the pelvis revealed the diffuse collection of gas in the wall of the urinary bladder (Picture 2). Emphysematous cystitis is a relatively rare complication of lower urinary tract infection (1). Abdominal pain is reported in 80% of cases, with hematuria in 47.6% cases and fever in 47.6% cases. Abdominal radiography is extremely sensitive (97.4%), although computed tomography is the
most sensitive and specific tool for diagnosis (2). It is important to keep in mind that emphysematous cystitis can be a rare cause of hematuria and may occur in the elderly and/ or diabetic patients. The author states that he has no Conflict of Interest (COI).
References 1. Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphysematous cystitis: a review of 135 cases. BJU Int 100: 17-20, 2007. 2. Grupper M, Kravtsov A, Potasman I. Emphysematous cystitis: illustrative case report and review of the literature. Medicine (Baltimore) 86: 47-53, 2007.
Department of Clinical Tropical Medicine, Mahidol University, Thailand Received for publication November 10, 2014; Accepted for publication November 30, 2014 Correspondence to Dr. Yoshiro Hadano, [email protected] Ⓒ 2015 The Japanese Society of Internal Medicine Journal Website: http://www.naika.or.jp/imonline/index.html
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