Angioembolisation for Emphysematous Cystitis Presenting as Gross Haematuria: A Case Report

Emphysematous cystitis is a rare infectious condition of the urinary bladder and carries significant morbidity and mortality especially if diagnosed late. Case history: We report a case of emphysematous cystitis with the unusual presentation of gross haematuria. A 76 years old diabetic lady presented to the Emergency Department with gross haematuria and falling haematocrit. CT angiography of the KUB region revealed ongoing bleed from the right vesical arteries with bladder intramural gas suggesting emphysematous cystitis. Angioembolisation of the bleeders followed by cystoscopic clot evacuation and bladder irrigation was done and adequate antibiotic therapy was started following which patient became better and was finally discharged in a stable condition. Discussion: We recommend CT for definitive diagnosis for emphysematous cystitis. High level of clinical suspicion, early antibiotic therapy, good glycemic control and bladder irrigation are needed for good management of the condition and prevention of complications