Cystitis
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A 71-year-old woman presented to the emergency room with confusion and coffee ground vomitus. Imaging revealed multiple gas pockets within her bladder wall, and she was diagnosed with emphysematous cystitis. Urine culture grew E. coli and she was treated intravenously with antibiotics. Her symptoms gradually improved and a follow up ultrasound showed a normal bladder wall. Emphysematous cystitis is a severe urinary tract infection characterized by gas accumulation in the bladder wall due to bacterial or fungal fermentation. It requires aggressive treatment with antibiotics and bladder drainage.
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![Dekeyzer and Houthoofd: Emphysematous CystitisArt. 66, page 2 of 2
How to cite this article: Dekeyzer, S and Houthoofd, B. Emphysematous Cystitis. Journal of the Belgian Society of Radiology.
2018; 102(1): 66, 1–2. DOI: https://doi.org/10.5334/jbsr.1192
Submitted: 02 September 2016 Accepted: 08 September 2016 Published: 12 October 2018
Copyright: © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons
Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
OPEN ACCESS
Journal of the Belgian Society of Radiology is a peer-reviewed open access journal
published by Ubiquity Press.
with parenteral antibiotics, bladder drainage and control
of sugar level and the overall average mortality rate is
approximately 7% [1].
Because of the nonspecific presentation, imaging plays
an important role in the diagnosis. Plain abdominal X-rays
can show a rim of gas lucency outlining the bladder wall
and/or air fluid levels within the bladder. Computed
tomography (CT) can more accurately define the extent
and severity of the disease, can detect cases that are
not apparent on plain radiography and can help in dif-
ferentiating emphysematous cystitis from colovesical
fistula, intra-abdominal abcesses, neoplastic disease or
emphysematous pyelonephritis.
Competing Interests
The authors have no competing interests to declare.
Reference
1. Amano, M and Shimizu, T. Emphysematous
cystitis: A review of the literature. Intern Med.
2014; 53: 79–82. DOI: https://doi.org/10.2169/
internalmedicine.53.1121](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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vomiting and weight loss. He was HIV positive since 2013 but discontinued antiretroviral therapy in 2019. At admission he was afebrile, with haemoglobin level of 12.8 g/dL
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
A 41-year-old man was transferred to our Infectious Diseases Unit
with a history of three weeks of fever, abdominal pain, nausea,
vomiting and weight loss. He was HIV positive since 2013 but discontinued antiretroviral therapy in 2019.
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
A 41-year-old man was transferred to our Infectious Diseases Unit
with a history of three weeks of fever, abdominal pain, nausea,
vomiting and weight loss. He was HIV positive since 2013 but discontinued antiretroviral therapy in 2019
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
A 41-year-old man was transferred to our Infectious Diseases Unit
with a history of three weeks of fever, abdominal pain, nausea,
vomiting and weight loss. He was HIV positive since 2013 but discontinued antiretroviral therapy in 2019. At admission he was afebrile, with haemoglobin level of 12.8 g/dL, leucocytes 4,340 cells/
mm³, platelets 237,000 cells/mm³, reative C protein 14.1 mg/dL,
urea 48 mg/dL, creatinin 0.98 mg/dL, n
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
A 41-year-old man was transferred to our Infectious Diseases Unit
with a history of three weeks of fever, abdominal pain, nausea,
vomiting and weight loss. He was HIV positive since 2013 but discontinued antiretroviral therapy in 2019. At admission he was afebrile, with haemoglobin level of 12.8 g/dL, leucocytes 4,340 cells/
mm³, platelets 237,000 cells/mm³, reative C protein 14.1 mg/dL,
urea 48 mg/dL, creatinin 0.98 mg/dL, n
4) Ultrasoubd for parasitic diseases.pptx
Ultrasound has several applications in diagnosing and assessing parasitic diseases:
1) It can identify characteristic ultrasound features of parasites that help in diagnosis of diseases like ascariasis and hydatid cysts.
2) It can detect characteristic pathology caused by parasites, as seen in schistosomiasis and amoebic liver abscess.
3) It guides needle biopsies and aspirates of organs infected by parasites like the liver.
4) It assesses the severity of conditions like schistosomiasis-induced liver fibrosis and monitors changes with treatment.
5) Portable ultrasound enables large-scale epidemiological studies in parasite-endemic areas.
RSNA 2009
Infectious, Inflammatory, & Neoplastic Conditions of the Retroperitoneum, Radiological Society of North America (2009)
Autoimmune Disease Presenting As Acute Abdomen
This document describes 3 cases of patients presenting with acute abdominal pain who were found to have mesenteric vasculitis and bowel ischemia due to underlying autoimmune disorders like systemic lupus erythematosus. Computed tomography imaging showed characteristic findings like bowel wall thickening, enhancement and dilation. The patients responded well to immunosuppressive therapies like steroids. The aim is to increase awareness of mesenteric vasculitis as a potential cause of acute abdomen among healthcare professionals.
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This document provides an overview of imaging diseases of the spleen. It begins with an introduction to the spleen's anatomy and function. Common imaging modalities for evaluating the spleen include CT, US, and MR. Patterns of splenic enhancement on imaging are described. Splenomegaly is defined on imaging as the spleen measuring greater than 13 cm or extending below certain anatomical landmarks. Causes of splenomegaly discussed include liver cirrhosis. Both cystic and solid splenic lesions are reviewed in detail, including simple cysts, abscesses, hemangiomas, and infections such as tuberculosis. Specific imaging findings that help characterize each splenic pathology are emphasized.
Imaging in Appendicitis
Acute appendicitis occurs when the appendiceal lumen is obstructed, leading to inflammation. CT and ultrasound are effective imaging modalities for diagnosis. On CT, findings suggestive of appendicitis include an appendix over 7mm in diameter, wall thickening, enhancement, and periappendiceal fat stranding. Ultrasound findings include an enlarged, non-compressible appendix with increased wall flow on Doppler. Both modalities can detect complications like perforation seen as fluid collections or abscesses. Accurate imaging allows avoiding negative appendectomies.
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Presentation1.pptx, ultrasound examination of the urinary bladder and prostate.
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acutecalculouscholecystitis-101101085001-phpapp01.pptx
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Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
Imaging of Diffuse B Cell Large Lymphoma in Liver, Kidneys, Pancreas and Myoc...
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Cor pulmonare algorithm
Cor pulmonale, also known as pulmonary heart disease, is a type of heart disease where the right side of the heart enlarges and fails over time due to high blood pressure in the lungs or pulmonary hypertension. It is usually caused by lung diseases like chronic obstructive pulmonary disease (COPD) that result in low oxygen levels and resistance within the pulmonary arteries of the lungs. The enlarged right ventricle must work harder to pump blood into the lungs, causing it to thicken and eventually fail if left untreated.
Peptic ulcer
Peptic ulcers develop in the lining of the stomach or small intestine. Common causes are infection by H. pylori bacteria and use of pain medications like ibuprofen. Symptoms include stomach pain that is worse when the stomach is empty. Diagnosis involves tests to detect H. pylori infection and endoscopy to view the digestive tract. Treatment eliminates the bacteria with antibiotics if present, reduces acid production, and promotes healing with proton pump inhibitors or acid blockers. Preventive measures include careful use of pain medications and protecting against infections.
Pancreatitis
Pancreatitis is inflammation of the pancreas that can be acute or chronic. It occurs when digestive enzymes in the pancreas are activated and damage pancreatic cells. Common causes include alcoholism, gallstones, certain medications, abdominal injuries, and genetic factors. Symptoms vary but often include abdominal pain that worsens with eating as well as nausea and vomiting. Diagnosis involves blood tests, imaging scans, and endoscopy. Treatment focuses on relieving symptoms, treating underlying causes, and managing complications. To prevent pancreatitis, avoiding excessive alcohol consumption and following a low-fat diet can help reduce risk.
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder defined by abdominal pain and changes in bowel habits. The causes are unclear but may involve stress, infection, or brain-gut interactions. Symptoms include abdominal pain, gas, bloating, and diarrhea or constipation. Diagnosis is based on symptoms, and tests rule out other conditions. Treatment focuses on lifestyle changes like diet, exercise, and stress relief. Medications may help control symptoms but no single treatment works for everyone with this common disorder.
Intestinal inflammatory disease
Inflammatory bowel disease (IBD) describes disorders that involve chronic inflammation of the digestive tract, including ulcerative colitis and Crohn's disease. The exact cause is unknown but is likely related to malfunctions of the immune system. Symptoms vary in severity from mild to severe and include diarrhea, abdominal pain, bleeding, and weight loss. Diagnosis involves blood tests, endoscopy, imaging, and ruling out other potential causes. Treatment aims to reduce inflammation and includes anti-inflammatory drugs, immunosuppressants, antibiotics, and surgery in some cases.
Infection by helicobacter pylori
Helicobacter pylori is a type of bacteria that infects the stomach and is the most common cause of gastritis and peptic ulcers worldwide. Infection is very common and increases with age. H. pylori bacteria can be transmitted through direct contact with infected feces or vomit, or through contaminated food or water. While most infected people never show symptoms, potential symptoms include abdominal pain, nausea, loss of appetite, and weight loss. Diagnosis involves tests of the blood, breath, or stool to detect H. pylori. Treatment consists of antibiotics along with medication to reduce stomach acid in order to kill the bacteria and allow the stomach lining to heal.
Gerd
Gastroesophageal reflux disease (GERD) occurs when stomach acid returns up into the esophagus and causes irritation. It is common for people to experience acid reflux occasionally, but GERD is when it occurs at least twice a week or more severely once a week. Risk factors include obesity, pregnancy, smoking, and certain medications. Symptoms include heartburn, nausea, coughing, and sore throat. Diagnosis is usually based on symptoms, but tests like endoscopy or pH monitoring can be done. Treatment involves lifestyle changes like losing weight, avoiding foods and drinks that trigger symptoms, and medications to reduce acid production. Surgery may be an option for severe cases that do not improve with other treatments.
Gastroenteritis
Gastroenteritis is inflammation of the stomach and intestines that is usually caused by viruses, bacteria, or parasites. Common symptoms include diarrhea, nausea, vomiting, and abdominal pain. While generally self-limiting, gastroenteritis can cause dehydration, which is more common and dangerous in infants and young children. Oral rehydration solutions are the recommended treatment for mild to moderate dehydration. Prevention involves proper food handling and drinking clean water, especially when traveling.
Gastroduodenal tumors
1. Gastrointestinal stromal tumors (GIST) are rare tumors that can develop in the wall of the gastrointestinal tract and can be cancerous (malignant) or non-cancerous (benign). Risk factors include inherited genetic mutations and rare genetic syndromes.
2. Symptoms of GIST tumors include blood in stool or vomit, abdominal pain, fatigue, difficulty swallowing, and feeling full after eating small amounts of food. Diagnosis involves physical exams, CT scans, MRI scans, endoscopic ultrasounds, and biopsies of suspicious tissue.
3. Treatment depends on the stage and location of the tumor and may involve surgical resection as the only potentially curative treatment
Gastritis
1. Gastritis is inflammation of the lining of the stomach that is usually caused by Helicobacter pylori infection or excessive alcohol or drug use. It can be acute or chronic.
2. Common causes include H. pylori infection, NSAIDs, alcohol, bile reflux, autoimmune disorders, and stress. Symptoms may include abdominal pain, nausea, vomiting, and black stools from bleeding.
3. Diagnosis involves blood tests, endoscopy, and stool tests. Treatment focuses on eliminating the cause, using antacids or other drugs to reduce stomach acid, and antibiotics to treat H. pylori infection. Preventing overuse of NSAIDs and limiting alcohol and sp
Esophageal motor disorders
1. Esophageal motor disorders are alterations in the peristaltic activity of the esophageal body and/or functioning of the sphincters. There are primary motor disorders that affect the esophageal body and lower esophageal sphincter including achalasia, diffuse esophageal spasm, and hypercontractile disorders.
2. The etiology of spastic motor disorders is divided into primary and secondary causes. The primary causes include diffuse esophageal spasm, nutcracker esophagus, and hypertensive lower esophageal sphincter. The pathophysiology involves alterations in nitric oxide synthesis and degradation affecting normal peristalsis.
3. Symptoms include chest pain, dysphagia
Dyspepsia
Dyspepsia, also known as indigestion, refers to discomfort or pain in the upper abdomen that is often caused by eating. Common symptoms include pain, swelling, heartburn, and nausea. While the specific cause is unknown in most cases, potential causes include stress, medications like aspirin, Helicobacter pylori bacteria, smoking, alcohol, spicy or greasy foods, and large meal sizes. Diagnosis involves tests like abdominal ultrasounds and endoscopies of the esophagus, stomach, and duodenum. Treatment focuses on diet changes, antibiotics to eliminate H. pylori if present, and medications to reduce acid like omeprazole. Prevention includes relaxing after
Disease of the rectum and anus
This document discusses diseases of the rectum and anus. It begins with definitions and explains that these diseases are commonly seen in primary care. It describes some of the main diseases including their causes, symptoms, and risk factors. Some of the diseases covered include hemorrhoids, anal fissures, abscesses, and anal cancer. The document discusses how these diseases are diagnosed, often through examination with an anoscope or sigmoidoscope. It also outlines treatments for some conditions like surgery, radiation therapy, and chemotherapy for anal cancer. Lastly, it discusses some ways to prevent diseases like avoiding risk factors, screening high risk patients, and vaccinations to prevent HPV infections.
Disease of the mouth cavity
The document discusses diseases of the mouth cavity. It defines the mouth and its functions, and describes common mouth problems like cold sores, canker sores, and infections. Diagnosis involves examination by a dentist, and treatment depends on the specific problem but may include cleaning, surgery, or maintenance visits. Prevention strategies include avoiding tobacco and excessive alcohol, eating fruits and vegetables, protecting lips from sun, and regular dental exams.
Digestive hemorrhage
The document discusses digestive hemorrhage, also known as gastrointestinal bleeding. It defines high and low hemorrhages based on their origin in the digestive tract. Some common causes of digestive hemorrhage include anal fissures, hemorrhoids, ulcers, and cancers of the digestive system. Symptoms include vomiting blood or black tarry stools. Diagnosis involves endoscopy, imaging tests, or surgery depending on the location of bleeding. Treatment focuses on stabilization, determining the cause through endoscopy, and addressing the specific condition causing the hemorrhage. Prevention strategies target those with risk factors like ulcers, cirrhosis, or who take anti-inflammatory drugs.
Diarrhea
1. Diarrhea is defined as more frequent bowel movements with soft and liquid stools. It is usually caused by viruses, bacteria, parasites, certain foods, medications, and other digestive disorders.
2. Symptoms of diarrhea include soft, watery stools, abdominal cramps, pain, fever, blood in stool, swelling, and urgency. It can cause dehydration, especially in children.
3. Doctors may perform blood tests, stool analysis, and imaging tests to diagnose the cause. Treatment depends on the cause but often involves replacing fluids and electrolytes, antibiotics if bacteria is involved, and managing any underlying conditions.
Constipation
Constipation is defined as having less than three bowel movements per week or hard stools that are difficult to pass. Common causes include low-fiber diets, lack of physical activity, certain medications, and ignoring the urge to have a bowel movement. Diagnosis involves physical exams, blood tests, and imaging tests of the colon and rectum. Treatment begins with lifestyle changes like increasing fiber intake and exercise. If those don't help, doctors may prescribe laxatives, stool softeners, or suppositories to relieve constipation symptoms.
Sleep apnea
Sleep apnea is a potentially serious sleep disorder where breathing stops and starts repeatedly during sleep. There are three main types - obstructive, central, and complex. Risk factors include being overweight, having a narrow throat, and certain facial structures. Symptoms include loud snoring, waking with shortness of breath, and daytime sleepiness. Diagnosis involves a physical exam and polysomnogram sleep test. Treatment options include lifestyle changes, CPAP devices, dental devices, and sometimes surgery. Losing weight and avoiding alcohol can help prevent sleep apnea.
Pulmonary tuberculosis
1. Pulmonary tuberculosis is a chronic infectious disease caused by the bacterium Mycobacterium tuberculosis, which usually affects the lungs. It spreads through the air when people who are sick with TB cough, sneeze or speak.
2. Symptoms include a persistent cough lasting more than two weeks, coughing up blood, weight loss, fever, night sweats and fatigue. Diagnosis involves physical exams, chest x-rays, sputum tests and tuberculosis skin tests.
3. Treatment involves a multi-drug regimen administered by a tuberculosis specialist to prevent drug resistance. Patients are advised to rest at home and cover their mouth when coughing to prevent spreading the disease until treatment has reduced their contagious
Pulmonary tromboembolia
1. Pulmonary embolism is caused by a blood clot in the lung, usually formed in the deep veins of the lower limbs. It is a leading cause of preventable death in hospitalized patients.
2. Symptoms include shortness of breath, chest pain, increased heart rate, coughing up blood, and fainting. Diagnosis involves assessing risk factors and test like D-dimer and CT scan.
3. Treatment involves anticoagulant drugs to dissolve clots initially by injection and then orally for 3-6 months. Prevention focuses on continuing anticoagulants, lifestyle changes like exercise and diet, wearing compression stockings, and early movement after surgery.
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Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
DR SHAMIN EABENSON - JOURNAL CLUB - NEEDLE STICK INJURY
DR SHAMIN EABENSON - JOURNAL CLUB - NEEDLE STICK INJURY
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
Cystitis
- 1. A 71-year-old woman was brought to the emergency room because of confusion and coffee ground vomitus. Physical examination was unremarkable. The abdomen was soft and non-tender. Laboratory tests showed normochro- mic normocytic anemia, elevated inflammatory param- eters and elevated kidney function tests. Urine analysis showed numerous red blood cells, white blood cells and bacteriae. Abdominal X-ray showed a curvilinear area of radiolucency delineating the bladder wall (Figure 1a). Non-contrast enhanced computed tomography (CT) of the abdomen revealed multiple gas pockets within the bladder wall (Figure 1b and 1c). A diagnosis of emphy- sematous cystitis was made and the patient was started empirically on intravenous piperacillin/tazobactom. Urine culture grew E. Coli and treatment was switched to intravenous levofloxacin. There was gradual clinical improvement of the patient. Control ultrasonography performed the week after admission showed a normal bladder wall. Emphysematous cystitis is an uncommon but severe lower urinary tract infection characterized by the accu- mulation of gas in and around the bladder wall produced by bacterial or fungal fermentation. The most common causative organisms are Escherichia Coli, Enterobacter Aerogenes and Klebsiella Pneumonia. The majority of patients are elderly, female and have type 2 diabetes mel- litus. The clinical presentation of emphysematous cystitis is nonspecific and varied, ranging from asymptomatic uri- nary tract infection to severe peritonitis or septic shock. Emphysematous cystitis requires aggressive treatment Dekeyzer, S and Houthoofd, B. Emphysematous Cystitis. Journal of the Belgian Society of Radiology. 2018; 102(1): 66, 1–2. DOI: https://doi.org/10.5334/jbsr.1192 * Universitair Ziekenhuis Antwerpen (UZA), BE † Sint-Andriesziekenhuis, Tielt, BE Corresponding author: Brecht Houthoofd (brecht.houthoofd@gmail.com) IMAGES IN CLINICAL RADIOLOGY Emphysematous Cystitis Sven Dekeyzer* and Brecht Houthoofd† Keywords: emhysematous cystitis; bladder; urinary tract; infection Figure 1: Conventional radiograph (a) in a case of emphysematous cystitis shows sharply demarcated, curvilinear areas of increased lucency in the pelvis. Computed tomography (b, c) images more clearly reflect the cobblestone aspect of intramural gas delineating the bladder wall, often likened to a “beaded necklace” appearance.
- 2. Dekeyzer and Houthoofd: Emphysematous CystitisArt. 66, page 2 of 2 How to cite this article: Dekeyzer, S and Houthoofd, B. Emphysematous Cystitis. Journal of the Belgian Society of Radiology. 2018; 102(1): 66, 1–2. DOI: https://doi.org/10.5334/jbsr.1192 Submitted: 02 September 2016 Accepted: 08 September 2016 Published: 12 October 2018 Copyright: © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/. OPEN ACCESS Journal of the Belgian Society of Radiology is a peer-reviewed open access journal published by Ubiquity Press. with parenteral antibiotics, bladder drainage and control of sugar level and the overall average mortality rate is approximately 7% [1]. Because of the nonspecific presentation, imaging plays an important role in the diagnosis. Plain abdominal X-rays can show a rim of gas lucency outlining the bladder wall and/or air fluid levels within the bladder. Computed tomography (CT) can more accurately define the extent and severity of the disease, can detect cases that are not apparent on plain radiography and can help in dif- ferentiating emphysematous cystitis from colovesical fistula, intra-abdominal abcesses, neoplastic disease or emphysematous pyelonephritis. Competing Interests The authors have no competing interests to declare. Reference 1. Amano, M and Shimizu, T. Emphysematous cystitis: A review of the literature. Intern Med. 2014; 53: 79–82. DOI: https://doi.org/10.2169/ internalmedicine.53.1121