嘔気が主訴で発見された気腫性膀胱炎

A case report on a patient with emphysematous cystitis found because of nausea

　症例は，コントロール不良な糖尿病がある58歳女性。今回，嘔気を主訴に当院を受診。腹部単純X線にて骨盤内にリング状のX線透瞭像，骨盤CTでは膀胱壁に沿って全周性に帯状のガス貯留を認めた。尿沈渣は，白血球20～29/HPF，赤血球30～49/HPFであった。以上より気腫性膀胱炎と診断し，尿道カテーテルを留置し，抗生剤投与を開始したところ，治療開始2日目には嘔気が消失し，3日目には膿尿が消失した。

　A 58-year-old female with uncontrollable diabetes mellitus visited our hospital complaining of nausea. Abdominal X-ray demonstrated gas collection around the bladder wall and pelvic CT scan demonstrated gas accumulation in the wall and lumen of the urinary bladder. Clean-catch urinalysis showed pyuria（urinary WBC,20～29/HPF）with microscopic hematuria. These findings were compatible with emphysematous cystitis. After bladder catheterization associated with antibiotics therapy,the symptoms of nausea improved and pyuria was no longer detected.