Abstract
An 82-year-old male visited our hospital with recurrent vomiting. This patient had type 2 diabetes and developed a slight fever of 37℃ and anorexia with the duration of a week. Abdominal CT revealed excessive accumulation of gas in the small intestine. He had increased plasma CPR levels and was hyperglycemic. Therefore, he was diagnosed as having an ileus and was hospitalized. The next day, the hypogastric pain increased and abdominal CT showed free gas in the pelvic cavity. Thus an exploratory laparotomy was performed with a preoperative diagnosis of gastrointestinal perforation. No gastrointestinal perforation was found during surgery, however, a snowball crepitation and edematous change were observed in the bladder wall. A cystoscope test showed submucosal accumulation of bubbles and he was diagnosed as having emphysematous cystitis. The treatment, which included urethral catheterization, antibiotics and insulin for glycemic control upon fasting, resolved the inflammation as well as the images of gas in the bladder wall. Additionally, we herein report on a case series of 6 cases of emphysematous cystitis seen over the course of a year.
