PMC3350004_01
Computed tomography scan of the abdomen showed air in the bladder and the thickened bladder wall, associated with air intra- and retroperitoneally.
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Furthermore, bilateral pleural fluid, some free fluid in the peritoneal cavity, and a few dilated jejunal segments without characteristics of bowel ischemia were seen (Figures 1(a) and 1(b)).
Patient developed a reddishness of the suprapubic region.
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A few hours later he was transferred to the intensive care unit (ICU) since he became more septic (hypotensive, tachycardiac, tachypneic) and developed a reddishness of the suprapubic region (Figure 2).
Zone of reddishness expanded up to the flanks bilaterally.
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Contrary to the clinical improvement, the zone of reddishness expanded up to the flanks bilaterally (Figure 3).
Control computed tomography scan of the abdomen showed necrosis of the bladder wall, predominantly the bladder dome and right bladder wall, with associated peritonitis signs.
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A control computed tomography scan of the abdomen showed necrosis of the bladder wall, predominantly the bladder dome and right bladder wall, with associated peritonitis signs (Figures 4(a) and 4(b)).
A cystography three weeks postoperatively showed some contrast extravasation into the space of Retzius.
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A cystography three weeks postoperatively showed some contrast extravasation into the space of Retzius (Figures 5(a) and 5(b)).
A control cystography six weeks postoperatively revealed no contrast leakage anymore.
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A control cystography one week later revealed no contrast leakage anymore (Figure 6).