An unusual case of air within the bladder wall: Bladder pneumatosis?

Polo, J. Medina; Nuñez-Sobrino, Juan Antonio; Díaz-González, Rafael

doi:10.1111/j.1442-2042.2011.02748.x

Cited by 7 publications

(6 citation statements)

References 9 publications

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“…This manuscript describes a rare case of pneumatosis cystoides intestinalis (PCI) under immune-suppressive condition with anti-cancer chemotherapy. 1 In this patient, pneumoperitoneum and air lesion within bladder wall were recognized at the same time.…”

Section: Editorial Comment To An Unusual Case Of Air Within the Bladdmentioning

confidence: 51%

“…Clinical manifestations of both diseases range from incidental findings to a severe and life-threatening form. 1,9 However, PCI most often follows a benign course, and might either regress spontaneously, or might follow a chronic course with intermittent disease activity. The treatment of choice for asymptomatic patients is non-operative management, even with the presence of free intraperitoneal air.…”

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confidence: 99%

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Editorial Comment to An unusual case of air within the bladder wall: Bladder pneumatosis?

Shichijo

2011

Int J of Urology

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Furthermore, break mucosal integrity of the bowel wall might permit entry of intraluminal gas. However, a mucosal lesion cannot be frequently shown and when mucosal lesions are present, they are usually far from the PCI. For example, in cases involving bowel obstruction, the cystic lesions are more commonly located distally to obstructive lesions rather than being located more proximally. 4,7,8 A combination of both theories might play a role in the pathogenesis of this case; on one hand , mechanical forces, especially increased intraluminal pressure and increased peristalsis as a result of constipation; on the other hand , air from ruptured alveoli might dissect along vessels and lymphatic channels reaching the bladder.Clinical manifestations of both diseases range from incidental findings to a severe and life-threatening form.

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Section: Editorial Comment To An Unusual Case Of Air Within the Bladdmentioning

confidence: 51%

mentioning

confidence: 99%

Editorial Comment to An unusual case of air within the bladder wall: Bladder pneumatosis?

Shichijo

2011

Int J of Urology

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“…While there have been reported cases of bladder perforation in patients presenting with emphysematous cystitis and pneumoperitoneum that required surgical intervention [4,10], there are also cases of emphysematous cystitis and pneumoperitoneum that were successfully managed conservatively, including our case [6,11]. As there is no established standard management for this situation, we performed a literature review to describe the clinical characteristics, management, and outcomes of these patients.…”

Section: Discussionmentioning

confidence: 99%

Successful Conservative Management of Emphysematous Cystitis With Pneumoperitoneum: A Case Report and Literature Review

Murata,

Matsuo,

Hiraoka

2023

Cureus

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Emphysematous cystitis is a rare type of urinary tract infection that is characterized by the accumulation of gas within the walls and lumen of the urinary bladder. In rarer instances, pneumoperitoneum may accompany emphysematous cystitis. When pneumoperitoneum is suspected through imaging studies in patients with emphysematous cystitis, surgical abdominal exploration is frequently performed considering the possibility of bladder perforation or coexistence of intestinal perforation. We successfully managed a case of emphysematous cystitis accompanied with pneumoperitoneum conservatively. A 90-year-old woman hospitalized with a gastric ulcer developed abrupt lower abdominal pain and hematuria. Contrast-enhanced CT revealed gas within the bladder wall, which was consistent with emphysematous cystitis, and pneumoperitoneum. No obvious bowel or bladder perforation was observed in the CT scan. Regarding her high surgical risk and clinical stability, surgical abdominal exploration was not performed, and she was managed conservatively with urethral catheter placement and antibiotics. She recovered with the treatment, and CT imaging obtained on day 18 demonstrated resolution of the bladder wall emphysema and no signs of pneumoperitoneum. We performed a literature review using MEDLINE and Japana Centra Revuo Medicina Web and confirmed 13 previously reported cases of emphysematous cystitis and pneumoperitoneum. Based on the review of these 13 cases and our case, it is difficult to predict the presence of bladder perforation solely based on peritoneal signs in physical findings or ascites on CT scans. Therefore, it would be preferable to perform surgical abdominal exploration to make a definite diagnosis and select an appropriate treatment. However, the fact that at least eight out of the 10 cases managed conservatively survived suggests that there is a specific clinical entity among patients who present with emphysematous cystitis and pneumoperitoneum that can be safely managed conservatively. Further accumulation of cases and research is necessary to determine which cases can be treated conservatively.

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“…Emphysematous cystitis (EC) is a potentially life-threatening condition that is characterized by air within the wall of the bladder as a result of infection by gas-forming organisms, but it may not always be the case. In cases where there is no clear etiology, medical management may be the most appropriate, as the pathogenesis may be similar to PCI [6][7][8]. However, it is unusual to see pneumatosis of the small bowel and bladder simultaneously.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Pneumatosis of Small Bowel and Bladder

Gupta

Vazquez

Lopez-Viego

2020

Cureus

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An 81-year-old woman presented with multiple episodes of loose bowel movements. CT scan of the abdomen and pelvis revealed pneumatosis cystoides intestinalis and asymptomatic emphysematous cystitis. The patient had an extensive workup with no obvious identified pathology to explain diffuse pneumatosis of the small bowel and bladder. Her symptoms improved with symptomatic management, empirical antibiotics, and no surgical intervention.

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An unusual case of air within the bladder wall: Bladder pneumatosis?

Cited by 7 publications

References 9 publications

Editorial Comment to An unusual case of air within the bladder wall: Bladder pneumatosis?

Editorial Comment to An unusual case of air within the bladder wall: Bladder pneumatosis?

Successful Conservative Management of Emphysematous Cystitis With Pneumoperitoneum: A Case Report and Literature Review

Idiopathic Pneumatosis of Small Bowel and Bladder

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