気腫性膀胱炎の3例

Abstract

症例1(71歳女性).肉眼的血尿を主訴とした.胃癌で胃全摘, 胆嚢・脾臓合併切除, 糖尿病の既往があり, 術後癌性腹膜炎を発症した.症例2(59歳男性).腹部膨満感を主訴とした.脳梗塞で入院中であったが, 糖尿病, 高血圧の既往はなかった.症例3(67歳男性).下腹部痛を主訴とした.直腸癌切除術後, 神経因性膀胱炎に対し内服治療中であった.全例, 排泄性尿路造影, 腹部X線, CT等で膀胱腔内, 膀胱壁にガス像を認め, 気腫性膀胱炎と診断, 抗菌剤の投与によりガス像は消失し, 症状は改善した.尿培養では症例1はKlebsiella pneumoniae, 症例2, 3はEscherichia coliが検出された

Emphysematous cystitis is a rare form of acute cystitis presenting with gas collection in the bladder wall and lumen. We report three cases of emphysematous cystitis. The first patient was a 71-year-old woman with gross hematuria. Intravenous pyelography and cystoscopy revealed a characteristic gas collection in the bladder. The second patient was a 59-year-old man with abdominal fullness who was hospitalized for treatment of a cerebral infarction. Abdominal radiography and computed tomographic (CT) scan demonstrated emphysematous cystitis. The third patient was a 67-year-old man with diarrhea and abdominal pain after operation for rectal cancer. CT scan accidentally showed gas bubbles in the bladder wall and lumen. All of the cases, the symptoms were improved after treatment with antibiotics.