[A Case of Emphysematous Cystitis with Air Bubbles in the Vena Cava, Pulmonary Artery and Brachiocephalic Vein].

A 78-year-old woman came to our emergency room because of loss of consciousness. Blood tests showed an elevated inflammatory response, and a computed tomography (CT) scan showed emphysematous cystitis. In addition, air bubbles were observed in the inferior vena cava, pulmonary artery, and brachiocephalic vein. We considered that they came from emphysematous cystitis. After admission to our hospital, we started antibiotics, placed a urethral catheter, and controlled the hyperglycemia. The patient's emphysematous cystitis resolved, and a CT scan performed on the 9th day of her hospitalization showed the disappearance of air bubbles. Emphysematous cystitis is caused by the accumulation of gas produced by gas-producing bacteria in the bladder wall or bladder cavity. It is a relatively rare disease with a high mortality rate of about 2-7%. Emphysematous cystitis with air bubbles in the venous system is rare. To our knowledge this is the first report of air bubbles in the brachiocephalic vein. In this report, we describe a case of emphysematous cystitis with air bubbles in the inferior vena cava, pulmonary artery and brachiocephalic vein.