糖尿病に合併した気腫性膀胱炎

A case of emphysematous cystitis

　症例は72歳，女性。糖尿病による嘔気・嘔吐で当院内科入院中，導尿時に肉眼的血尿を認め当科を紹介され初診した。検尿では感染による膿尿を認めた。単純X線写真では膀胱部に異常なガスの集積を認め，CT検査では膀胱壁内ガスの貯留を認めた。尿培養では大腸菌が検出された。以上より気腫性膀胱炎と診断し，ドレナージ目的にバルーンを留置し抗生剤の投与を行った。カテーテル留置開始後6か月の現在，再発を認めていない。

A 72-yaer-old woman was referred to our hospital with a complaint of nausea and vomiting due to diabetes mellitus. Macroscopic hematuria was observed at the time of catheterization. The results of urine analysis showed hematopyuria and bacteriuria. An X-ray film showed an abdominal gas collection around the urinary bladder. CT scan revealed diffuse collection of gas along the bladder wall. Urine culture isolated Escherichia coli. The diagnosis of emphysematousatous cystitis was made. A urinary balloon catheter was indwelled for drainage and antibiotics were administered effectively. We reviewed 61 cases of emphysematousatous cystitis reported in Japan.