Abstract
A 64-year old female patient presented to the emergency department with complaints of acute lower abdominal pain. She had poorly controlled hyperglycemia and multiple cranial glial tumors treated with steroids and radiotherapy. Her vital signs were body temperature 36.5 °C, blood pressure 110/70 mmHg, and heart rate 90 beats per minute. Her physical examination revealed lower abdominal pain. Her laboratory tests showed blood glucose 259 mg/dL (70–105), leukocytes 16.5 103/uL (4.23–9.07), C-Reactive protein (CRP), 8.49 mg/dL (0–0.34). Gram negative bacilli were detected on direct microscopic examination of urine. Contrast-enhanced abdominal tomography is shown in Fig. 1, Fig. 2. Fig. 1 Contrast-enhanced abdominal tomography showed gas in the bladder wall and an air-fluid level within the lumen of the bladder. Fig. 2 Contrast-enhanced abdominal tomography showed gas in the bladder wall and an air-fluid level within the lumen of the bladder.
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