{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:04:49Z","timestamp":1785769489968,"version":"3.56.0"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n Introduction and Importance:<\/jats:title>\n Gangrenous cystitis (GC) is an extremely rare yet life threatening condition. It commonly presents as urosepsis. We report an unusual case of GC in a frail patient that initially manifested as an abdominal wall collection.<\/jats:p>\n <\/jats:sec>\n \n Case Presentation:<\/jats:title>\n \n We report a 70-year-old female, frail bedridden patient undergoing urinary catheterization with history of secondary recurrent urinary tract infection, presenting with an abdominal wall reddish and necrotized lesion. CT scan revealed a 14\u00d78\u00d75 cm collection involving the left anterolateral abdominal wall with a thickening of the bladder wall and the sigmoid. An exploratory laparotomy was performed revealing a gangrenous cystitis confined to the bladder\u2019s dome. Excision of the gangrenous tissue with primary closure of the bladder was performed. Postoperative course was fatal within 24\u00a0hours due to septic shock. Postmortem urine culture isolated an extended-spectrum beta-lactamase-producing\n Escherichia coli<\/jats:italic>\n resistant to most \u03b2-lactams except for susceptibility for carbapenems and piperacillin\u2013tazobactam.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion:<\/jats:title>\n In our patient, two etiological factors were identified: indirect \u2013 bladder overdistension secondary due to insufficient intermittent catheterization \u2013 and direct: urinary tract infection. Surgery remains the only lifesaving treatment in CG. In cases of unaffected trigone, it ranges from simple excision with adequate urinary drainage, to subtotal cystectomy. In more extensive disease involving the trigone, a radical total cystoprostectomy with bilateral ureterostomy is necessary.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Via this misleading presentation of GC, we emphasize the importance of recognition of subtle symptoms in establishing early diagnosis in frail patients. Adherence to catheterization protocols and surveillance is paramount in patients undergoing intermittent or long-term indwelling urinary catheterization to prevent severe urinary complications.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/rc9.0000000000000085","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T09:00:07Z","timestamp":1769590807000},"page":"731-734","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Gangrenous cystitis presenting as an abdominal wall collection in an old frail patient: a case report"],"prefix":"10.1097","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3949-2669","authenticated-orcid":false,"given":"Essid","family":"Nada","sequence":"first","affiliation":[{"name":"Department of Visceral surgery and liver transplantation, CHU Mongi Slim, Tunis, Tunisia"},{"name":"University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7737-0356","authenticated-orcid":false,"given":"Atallah","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Visceral surgery and liver transplantation, CHU Mongi Slim, Tunis, Tunisia"},{"name":"University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5048-3755","authenticated-orcid":false,"given":"Hadrich","family":"Zied","sequence":"additional","affiliation":[{"name":"Department of Visceral surgery and liver transplantation, CHU Mongi Slim, Tunis, Tunisia"},{"name":"University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7085-2167","authenticated-orcid":false,"given":"Sellami","family":"Sahar","sequence":"additional","affiliation":[{"name":"Department of Visceral surgery and liver transplantation, CHU Mongi Slim, Tunis, Tunisia"},{"name":"University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1624-2923","authenticated-orcid":false,"given":"Hajri","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Visceral surgery and liver transplantation, CHU Mongi Slim, Tunis, Tunisia"},{"name":"University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1785-2192","authenticated-orcid":false,"given":"Omrani","family":"Sahir","sequence":"additional","affiliation":[{"name":"Department of Visceral surgery and liver transplantation, CHU Mongi Slim, Tunis, Tunisia"},{"name":"University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"R1-20260803","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1159\/000321010","article-title":"Gangrenous cystitis: report of a case and review of the literature","volume":"85","author":"Hinev","year":"2010","journal-title":"Urol Int"},{"key":"R2-20260803","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1007\/s00192-007-0430-9","article-title":"Gangrenous cystitis","volume":"18","author":"Ballas","year":"2007","journal-title":"Int Urogynecol J"},{"key":"R3-20260803","first-page":"100079","article-title":"Revised Surgical CAse REport (SCARE) guideline: An update for the age of Artificial Intelligence","volume":"10","author":"Kerwan","year":"2025","journal-title":"Prem J Sci"},{"key":"R5-20260803","doi-asserted-by":"crossref","first-page":"005","DOI":"10.17352\/aur.000005","article-title":"Case report of gangrenous cystitis in a post-partum female","volume":"3","author":"Prabhat","year":"2019","journal-title":"Arch Urol Res"},{"key":"R6-20260803","first-page":"102239","article-title":"Rare case of gangrenous cystitis revealed by acute peritonitis","volume":"45","author":"Elalaoui","year":"2022","journal-title":"Urol Case Rep"},{"key":"R7-20260803","doi-asserted-by":"crossref","first-page":"bcr\u20132016\u2013217769","DOI":"10.1136\/bcr-2016-217769","article-title":"Bladder necrosis: \u2018A man without a bladder\u2019","volume":"2018","author":"Bosschieter","year":"2018","journal-title":"BMJ Case Rep"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000085","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:13:30Z","timestamp":1785766410000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/rc9.0000000000000085","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"assertion":[{"value":"2025-09-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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