Emphysematous cystitis

Author: Nat Pernick, M.D. (see Authors page)

Revised: 11 July 2018, last major update July 2011

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Bladder emphysematous cystitis
Cite this page: Pernick, N. Emphysematous cystitis. website. Accessed October 18th, 2018.
Definition / general
  • Rare entity, associated with diabetes, with gas filled cysts in bladder wall
  • 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
  • Antibiotics, relieve bladder obstruction
Microscopic (histologic) description
  • Cysts often lined by multinucleated giant cells