- Page navigation anchor for RE: Bladder perforation: an important, rare complication of emphysematous cystitisRE: Bladder perforation: an important, rare complication of emphysematous cystitis
We read with interest the case report published by Dr. Liao about emphysematous cystitis and its potential complications.1 An important, although rare, complication not mentioned in their article is bladder perforation.2-4 The mainstay of emphysematous cystitis treatment is prompt bladder decompression and antibiotic therapy targeted at the offending organism. Unfortunately, little literature exists about the duration the bladder should undergo drainage. Post-treatment bladder perforation is possible.
We recently encountered a case of emphysematous cystitis in an elderly female patient who was status post primary debulking for ovarian carcinosarcoma. Her procedure had been complicated by cystotomy and her post-operative course was complicated by colo-colonic fistula. The infection was incidentally noted on CT imaging to investigate a bowel-related complication. Urine culture demonstrated Klebsiella pneumoniae. Urology and Infectious Diseases were consulted and recommended antibiotic therapy and bladder drainage via Foley catheter. A test for diabetes (glycated hemoglobin) was negative. She was given a ten day course of antibiotics and then her catheter was removed. During this interval, she underwent diverting ileostomy; intra-operatively, bladder integrity was confirmed via instillation of methylene blue. When her catheter was removed she had no urine output per urethra and her pelvic Jackson-Pratt drain (in situ for drainage of colonic fistula) output increased. D...
Show MoreCompeting Interests: None declared.References
- Po-Hsiang Liao, Ming-Shun Hsieh, Yen-Chia Chen. Emphysematous cystitis. CMAJ 2020;192:E313-E313.
- Qin Y et al. Emphysematous cystitis complicated by urinary bladder perforation: a case report. Proceedings of Singapore Healthcare 2012; 21: 140-3.
- Amano M and Shimizu T. Emphysematous cystitis: a review of the literature. Internal Medicine 2014; 53: 79-82.
- Roels P et al. Spontaneous bladder wall rupture due to emphysematous cystitis. Journal of the Belgian Society of Radiology 2016; 100: 83.
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