產氣性膀胱炎造成膀胱空氣填塞

陳妤甄¹、陳浩瑋¹、蔡嘉駿^{1, 2}、阮雍順^{1, 2}

高雄醫學大學附設醫院 泌尿部¹；高雄市立大同醫院 泌尿科²

Gaseous bladder tamponade due to emphysematous cystitis

Yu-Chen Chen¹, Hao-Wei Chen¹, Chia-Chun Tsai^1,2 ,Yung-Shun Juan^1,2

Divisions of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan ¹

 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan ²

A 81-year-old man presented to the emergency department with 2 days history of fever, progressed low abdominal distention and decreased urine output. He had had type 2 diabetes mellitus and flaccid neurogenic bladder with long-term indwelling Foley catheter for the preceding 2 years. Laboratory studies revealed bacteriuria, leukocytosis (a white-cell count of 14,710 per cubic millimeter), an elevated C-reactive protein level (63 mg per liter), high fasting blood glucose (302 mg per deciliter), and an elevated creatinine level (2.05 mg per deciliter). Abdominal radiography and computed tomography revealed gas tamponade in the bladder with bilateral obstructive hydronephrosis. A new Foley catheter was changed, and bladder irrigation was performed to extract pus and gas. Both blood and urine cultures grew Klebsiella pneumonia. The patient was treated with a full course of broad-spectrum antibiotics; then the condition of infection and acute kidney injury were resolved.