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Cholecystitis01:20

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Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
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Necrosis is a form of irreversible cell death caused by severe injury such as ischemia, toxins, or trauma. Unlike programmed cell death, it is an uncontrolled, pathological process that typically provokes inflammation in surrounding tissues.Pathophysiologic ChangesNecrosis begins when cells sustain critical damage, leading to swelling of organelles, particularly mitochondria, and rapid ATP depletion. As energy levels decline, membrane ion pumps fail, leading to calcium influx and eventually,...
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The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...
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Updated: Apr 25, 2026

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Emphysematous cystitis and necrotizing fasciitis.

Peter Zhan Tao Wang1, Paul R Martin1, Patrick P W Luke1

  • 1Schulich School of Medicine & Dentistry, University of Western Ontario, Division of Urology, Department of Surgery, London, ON.

Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada
|August 19, 2014
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Summary

This case report details a rare instance of emphysematous cystitis and necrotizing fasciitis in a male patient. Aggressive surgical intervention was required for both severe conditions, highlighting a unique clinical presentation.

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Area of Science:

  • Urology
  • Infectious Diseases
  • Surgery

Background:

  • Emphysematous cystitis is a rare bladder infection, typically affecting women and diabetics.
  • Necrotizing fasciitis is a severe soft tissue infection requiring urgent surgical management.

Purpose of the Study:

  • To report the first known case of concomitant emphysematous cystitis and necrotizing fasciitis in a male patient.
  • To describe the aggressive surgical management required for these co-occurring severe conditions.

Main Methods:

  • Case report of a 62-year-old male patient.
  • Initial management included right leg disarticulation.
  • Subsequent cystoprostatectomy with ileal conduit was performed due to treatment failure.

Main Results:

  • The patient presented with simultaneous emphysematous cystitis and necrotizing fasciitis.
  • Tissue cultures identified Ciprofloxacin-resistant Klebsiella pneumoniae.
  • Despite initial treatment with Piperacillin-Tazobactam, conservative management failed, necessitating extensive surgery.

Conclusions:

  • Concomitant emphysematous cystitis and necrotizing fasciitis is an exceptionally rare presentation.
  • Aggressive surgical intervention may be required for both conditions.
  • This case underscores the importance of considering multiple severe infections in complex presentations.