CT Abdomen and Pelvis

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65 year old female presents with a 2 week history of lower abdominal pain and dysuria. A CT Abdomen and Pelvis with oral and IV contrast was performed. What is the major pathology present in this study which would explain this patient's symptoms? What is the most likely cause? The significant abnormality in this scan involves the bladder. There is bladder wall thickening, most marked on the lateral aspect where it measures up to 20mm. Additionally, there is significant perivesical stranding and gas within the bladder lumen and wall. The kidneys are normal in appearance. There is no evidence of diverticular disease involving the adjacent sigmoid colon. These radiological features are consistent with anaerobic cystitis. Incidentally, did you note the surgical staple line along the stomach wall?

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