IMAGES IN MEDICINE
Emphysematous cystitis with perforation in a non-diabetic patient
1 Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China
2 Chung Shan Medical University, Taiwan, Republic of China
3 National Taichung Nursing College, Taiwan, Republic of China
Correspondence to:
Dr S-Y Hu, No 160, Section 3, Chung-Kang Road, Taichung, Taiwan, Republic of China 00407; song9168@pie.com.tw
Accepted 4 January 2009
Keywords: cystitis; radiology; imaging; urology
| The first 150 words of the full text of this article appear below. |
An 82-year-old woman with a history of adenoid cystic carcinoma of the left lower lung, who had undergone surgery and radiotherapy in 1998, presented to our emergency department complaining of abdominal fullness for 1 day. Physical examination revealed tympanicity on percussion and tenderness over the lower abdomen. Laboratory evaluation revealed white blood cell counts (WBCs) 22 500 per cubic mm with 91.6% segmented neutrophils, haemoglobin 11.3 g/dl, blood urea nitrogen 15 mg/dl, creatinine 0.8 mg/dl, blood sugar 156 mg/dl, lactate 75.3 mg/dl (normal <12 mg/dl), and C reactive protein 11.7 mg/dl (normal <0.4 mg/dl); other results were unremarkable. Spot urine analysis showed 20
35 WBCs per high power field. A plain radiograph of the kidney–ureter–bladder (fig 1A) showed intraluminal air within the urinary bladder, outlining its perimeter. A computed tomographic (CT) scan of the abdomen (fig 1B) revealed gas accumulation in the wall and lumen of
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