• Affes Nejmeddine, Bahloul Atef, Dammak Youssef, Beyrouti Ramez, and Beyrouti Mohamed Issam.
• Department of General Surgery, Habib Bourguiba Hospital, Sfax, Tunisia.
• N Am J Med Sci. 2009 Aug 1;1(3):114-6.

BackgroundEmphysematous cystitis is defined by the presence of gas in the urinary bladder wall. It complicates urinary tract infections especially in diabetic patients.AimsWe present a case of emphysematous cystitis in a diabetic patient with a poor glycemia control and we discuss diagnostics and treatment items of this uncommon and serious infection.Methods And ResultsA 45-year-old man was admitted to the emergency department with confusion and abdominal pain. The clinical examination found a septic shock the Ultra-sonography (US) showed a cholecystitis the patient was operated without amelioration. A post operative pelvic computed tomography (CT) demonstrated intramural gas in the urinary bladder, which suggested a diagnosis of emphysematous cystitis. The treatment was based on an antibiotics associated with a bladder drainage. The evolution was in favor.ConclusionEvery diabetic patient with a urinary tract infection who seems to be severely ill should have an abdominal X-ray as a minimal screening tool to detect emphysematous complications.

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