Abstract
Emphysematous cystitis is a severe urinary tract infection which threatens patients’ life. Thus, it requires early diagnosis and computed tomography (CT) is the reference medical exam used to address it. However, ultrasound, which is a non-ionizing and very accessible technique, may also contribute to diagnosis. The aim of this study was to illustrate the contribution of ultrasound to the diagnosis of emphysematous cystitis. We report three cases of emphysematous cystitis diagnosed by ultrasound. In all the cases, ultrasound identified basic signs showing presence of gas, including a hyperechoic cystic parietal thickening, repeat echoes and dirty shadow cones of intraluminal focus. Diagnostic confirmation was made in two cases through X-ray and in one case by means of computed tomography. Through simple basic signs, ultrasound directs most usefully towards an emphysematous urinary tract infection. CT enables a more accurate diagnostic work-up of lesions and differential diagnosis with vesico-digestive fistula.
Highlights
Emphysematous cystitis is an acute urinary infection which threatens patients’ life [1]
The clinical signs of emphysematous cystitis are variable; they range from uncomplicated pollakiuria to abdominal pain with hematuria; sometimes, disorders of consciousness may be indicative factors
Medical imaging contributes to early diagnosis by identifying air and specifying location on the urinary tract
Summary
Emphysematous cystitis is an acute urinary infection which threatens patients’ life [1] It is an infrequent infection characterized by gas presence in bladder lumen and/or wall. Treatment is based on triple antibiotic therapy adapted to antimicrobial susceptibility testing associated with bladder drainage, and in diabetic patients to glycemic control This disease severity is mainly associated with late diagnosis and treatment. Due to the poor specificity of clinical signs, computed tomography is not always the first medical imaging exam used This technique is not accessible enough in developing countries, including Benin. Ultrasound, a non-ionizing and more accessible technique, can significantly contribute to diagnosis [6] [7] In the literature, it is not commonly used as a diagnostic tool [1] [8]. The study of three cases of emphysematous cystitis enabled the authors to emphasize ultrasound contribution to the diagnosis of those horrific infections
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