Emphysematous cystitis as a potential marker of severe Crohn's disease.
Background: Emphysematous cystitis (EC) is characterized by the presence of air within the bladder wall, often a complication of urinary tract infection (UTI) by gas-producing organisms. However, EC has also been reported in the setting of infectious colitis suggesting an alternate etiology. We repo...
| Publicado en: | BMC Gastroenterology Vol. 22; no. 1; pp. 1 - 7 |
|---|---|
| Autores principales: | , |
| Formato: | case study Journal Article |
| Publicado: |
BioMed Central
4/11/2022
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156244096&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156244096 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1471230X 1CHO jtl: BMC Gastroenterology issn: 1471230X maglogo: N pubinfo: dt: 4/11/2022 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 156244096 156244096 NLM35410166 156244096 10.1186/s12876-022-02253-6 NLM35410166 156244096 ppf: 1 ppct: 6 formats: tig: atl: Emphysematous cystitis as a potential marker of severe Crohn's disease. aug: au: Hasan, S. M. Mahmudul Salh, Baljinder S. affil: Health Sciences Centre, Memorial University of Newfoundland, 300 Prince Phillip Drive, A1B 3V6, St. John's, NL, Canada sug: subj: Cystitis Colitis Complications Crohn Disease Diagnosis Cystitis Complications Intestinal Fistula Female Adult Scales Adult: 19-44 years Female ab: Background: Emphysematous cystitis (EC) is characterized by the presence of air within the bladder wall, often a complication of urinary tract infection (UTI) by gas-producing organisms. However, EC has also been reported in the setting of infectious colitis suggesting an alternate etiology. We report a rare case of EC in the setting of severe Crohn's colitis with no clinical evidence of UTI.Case Presentation: A 43-year old female presented with a 2-month history of bloody diarrhea consisting of 8-12 bowel movements a day, weight loss of 10 kg and peripheral edema. She also had multiple ulcerated lesions on her abdominal wall and in the perianal region. Initial CT scan was significant for pancolitis, anasarca and EC. The follow-up CT cystogram, flexible cystoscopy and pelvic MRI confirmed the diagnosis of EC and ruled out any fistulous tracts in the pelvis including enterovesical/colovesical fistula. The patient did not report any urinary symptoms and the urinalysis was within normal limits. An extensive infectious workup was negative. Despite the paucity of infectious findings, the EC was empirically treated with an intravenous third-generation cephalosporin. Colonoscopy was significant for multiple ulcerated and hyperemic areas with pseudopolyps all throughout the right, transverse and left colon. Biopsies confirmed Crohn's colitis with no evidence of granulomata or dysplasia. Immunohistochemistry was negative for CMV. The perianal and abdominal wall lesions were suspected to be pyoderma gangrenosum although biopsies were equivocal. The colitis was initially treated with intravenous steroids followed by biologic therapy with Infliximab. Despite appropriate escalation of therapies, the patient developed colonic perforation requiring subtotal colectomy.Conclusion: This is a rare case of EC in a patient with severe Crohn's colitis. There was no evidence of urinary tract infection or fistulising disease. According to our review, this is the first reported incident of EC in a patient with inflammatory bowel disease without any prior intra-abdominal surgeries. While active Crohn's disease alone is a critical illness, we conclude that concomitant EC may be a poor prognostic factor. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|