Abstract
Emphysematous cystitis (EC) is a rare, potentially life-threatening urinary tract infection characterized by gas formation within the bladder wall and lumen, typically associated with diabetes, immunosuppression, or advanced age. We present the case of a 72-year-old woman with systemic sclerosis and hypothyroidism, who was admitted for an infected distal limb wound following femoropopliteal bypass. During hospitalization, she developed emphysematous cystitis accompanied by radiological features of intestinal pseudo-obstruction. Prompt diagnosis, conservative treatment with bladder catheterization and intravenous antibiotics, and multidisciplinary management resulted in clinical improvement. This case highlights the importance of early imaging and collaborative care in atypical urinary tract infections.