Bladder & urothelial tract
Cystitis
Emphysematous cystitis
Author: Nat Pernick, M.D.
Last author update: 1 July 2011
Last staff update: 23 November 2020
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Bladder emphysematous cystitis
Table of Contents
Definition / general | Epidemiology | Etiology | Clinical features | Radiology images | Case reports | Treatment | Microscopic (histologic) descriptionCite this page: Pernick N. Emphysematous cystitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderemphysematous.html. Accessed April 25th, 2024.
Definition / general
- Rare entity, associated with diabetes, with gas filled cysts in bladder wall
Epidemiology
- Median patient age is 66 years, 64% women, 67% had diabetes mellitus (BJU Int 2007;100:17)
Etiology
- Due to gas forming bacteria (Clostridium perfringes, E. coli, Enterobacter aerogenes), which produce gas filled cysts in bladder wall
- In one study, E. coli was most commonly isolated organism (J Microbiol Immunol Infect 2009;42:393)
- CO2 may be produced by microorganisms through fermentation of glucose
- There may also be impaired transportation of gas, due to local inflammation or other obstructive process (Braz J Infect Dis 2008;12:552)
Clinical features
- Associated with diabetes (50% of cases), chronic cystitis, neurogenic bladder, leukemia / lymphoma
- Commonly presents with pneumaturia
- Diagnosed by radiologic evidence of gas in bladder mucosa
- Rare complication is subcutaneous emphysema (Int J Emerg Med 2011;4:26)
Radiology images
Images hosted on other servers:
CT scan shows gas in bladder and bladder wall
CT scan of 77 year old woman without diabetes
Case reports
- 62 year old woman with E. coli infection and diabetes (Intern Med 2010;49:1879)
Treatment
- Antibiotics, relieve bladder obstruction
Microscopic (histologic) description
- Cysts often lined by multinucleated giant cells
