Presentation
Diabetic woman with non-specific abdominal pain and a palpable mass at the lower abdomen.
Patient Data
Abdominal plain radiograph obtained with the patient upright demonstrates gas within the bladder lumen and increased radiolucency representing air in the expected location of the urinary bladder with a few locules suggesting gas within its wall.
CT demonstrates gas within the lumen and the wall of the bladder.
Case Discussion
Emphysematous cystitis represents a rare form of acute inflammation of the bladder mucosa and underlying musculature. Clinical symptoms of dysuria, increased urinary frequency, and hematuria are common. The presence of pneumaturia is a rare, although more specific, clinical finding. Underlying diabetes mellitus is present in over half of reported cases, with women being affected twice as often as men.