気腫性膀胱炎を伴った膀胱自然破裂

Emphysematous Cystitis Resulting in Spontaneous Rupture of the Urinary Bladder

　56歳，女性。主訴は腹痛。ショック症状にて当院救命センターを受診した。画像診断より，気腫性膀胱炎を伴った腹腔外膀胱自然破裂と診断した。全身管理と尿道カテーテル留置，ドレナージを行ったが，死亡した。予後良好とされている気腫性膀胱炎でも，診断が遅れると致命的であるため，早期発見，早期治療が必要である。

A 56-year-old woman was brought to an emergency room in a state of shock, complaining of abdominal pain. Cystog-raphy and abdominal CT revealed spontaneous rupture of the urinary bladder was accompanied by emphysematouscystitis. Conservative treatment including an indwellingcatheter of the urinary bladder and subcutaneous drainagecombined with anti-shock therapies was not successful.Emphysematous cystitis is reported to have relatively good prognosis in the Japanese literature, but early detection and prompt treatment is mandatory especially of associated with bladder rupture.