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ABSTRACT: A 51-year-old woman with a recent history of intestinal strongyloidiasis, hyperthyroidism, and diabetes mellitus presented with consciousness disturbances and septic shock. At our intensive care unit, palpation of the lower abdominal area revealed a firm baseball-like mass. Acute urinary retention was considered, and the patient was catheterised with a Foley catheter. The effluent consisted of bloody urine with a large amount of air inside the drain bag. The results of laboratory evaluation revealed a white blood cell (WBC) count of 24,570 cells/mm 3 made up of 63% segmented and 28.5% band neutrophils, a haemoglobin level of 9.7 g/dl, and serum creatinine level of 1.1 mg/dl. Urinalysis showed numerous red blood cells and 5 to 10 WBCs/ml. Computed tomography (CT) images showed multiple air densities within the urinary bladder wall (figure 1). figure 1. After Foley catheterisation, abdomino-pelvic CT images revealed both intravesicular gas formation and a characteristic mottled 'cobblestone' appearance of radiolucency within the thickened urinary bladder wall (arrowheads)
The Netherlands Journal of Medicine 01/2012; · 2.07 Impact Factor
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