Bladder & ureters
Cystitis
Emphysematous cystitis


Topic Completed: 1 July 2011

Revised: 20 June 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Bladder emphysematous cystitis

Nat Pernick, M.D.
Page views in 2018: 365
Page views in 2019 to date: 262
Cite this page: Pernick N. Emphysematous cystitis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bladderemphysematous.html. Accessed August 25th, 2019.
Definition / general
  • Rare entity, associated with diabetes, with gas filled cysts in bladder wall
Epidemiology
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
Treatment
  • Antibiotics, relieve bladder obstruction
Microscopic (histologic) description
  • Cysts often lined by multinucleated giant cells
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