Perforated emphysematous cystitis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Diabetic patient, presented with symptoms of urinary tract infection.

Patient Data

Age: 65 years
Gender: Female

There is an intraluminal and intramural gas of the urinary bladder. Extra-vesical gas is also noted in the subperitoneal space on the right, indicating probably a perforated bladder wall.

Annotated image

Annotaed images:

  • red arrow; extra-vesical gas in the subperitoneal space
  • yellow arrow: probable site of perforation of the bladder wall

Case Discussion

CT features most consistent with perforated emphysematous cystitis. Diabetes mellitus is considered the commonest predisposing factor which may be present in ~50% of cases.

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