Emphysematous cystitis

Abstract

 An 87-year-old woman with a history of arterial hypertension, type 2 diabetes mellitus and high-grade bladder adenocarcinoma with multiple transurethral resections and pathological fracture (due to metastasis) of the right hip of 4 months of evolution presented with intractable pain. She was found to be septic and imaging showed gas in the bladder wall. Escherichia coli was isolated. An interdisciplinary board recommended conservative management and, despite aggressive antimicrobial therapy and supportive measures, she developed pneumoperitoneum and peritonitis and died three weeks after admission.