title: [Spontaneous bladder perforation secondary to bacterial cystitis. Cause of acute abdomen in diabetic elderly].
abstract: Presentation of two clinical cases of spontaneous vesical rupture secondary to bacterial cystitis in elderly patients. One corresponds to an intraperitoneal perforation while the second case was extraperitoneal. The patients were, in both cases, diabetic women admitted in emergency due to acute abdomen. We considered that although vesical perforation secondary to bacterial cystitis is a very uncommon process, it should be taken into account in the differential diagnosis of acute abdomen in predisposed patients (diabetic elderly patients with pyuria). In such instances, a retrograde cystography would provide the diagnosis. Although extraperitoneal vesical perforations can be resolved with a vesical catheter or cystostomy, extravasation of the infected urine may result in a perivesical abscess and septic shock. Early surgical management should be considered in these cases.
authors.affiliation: Servicio de Urología y Unidad de Trasplante Renal, Hospital Clínico, Universidad de Barcelona.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez Rodríguez
authors.forename: R
authors.initials: R
authors.lastname: Vendrell
authors.forename: P
authors.initials: P
authors.lastname: Luque
authors.forename: S
authors.initials: S
authors.lastname: López-Alvarado
authors.forename: A
authors.initials: A
authors.lastname: Alcaraz
authors.forename: P
authors.initials: P
authors.lastname: Carretero
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D003556:Cystitis / Q000150:complications*; D048909:Diabetes Complications; D004927:Escherichia coli Infections / Q000150:complications*; D005260:Female; D006801:Humans; D012422:Rupture, Spontaneous; D001745:Urinary Bladder Diseases / Q000209:etiology
vernacular_title: Perforación vesical espontánea secundaria a cistitis bacteriana. Causa de abdomen agudo en ancianos diabéticos.