Discuss the predisposing conditions and clinical features associated with gas-forming infections of the abdomen and pelvis. Describe and characterize most of the acute abdomino-pelvic emphysematous infection conditions involving the hepatobiliary and pancreatic system, genitourinary system,gastrointestinal systemand pelvis. Recognize and discuss the radiological appearance of an extremely rare entity: emphysematous hepatitis.

Acute abdominal pathology represents a substantial part of radiological emergencies. From this, emphysematous abdomino-pelvic infections, although infrequent, are potentially life-threatening entities that tend to appear insidiously in patients with multiples comorbidities and, often lead to a rapid progression towards sepsis. Certain underlying conditions such as diabetes and local ischemia play an important role in gas-forming infections by certain bacterial species that will end up producing this type of emphysematous conditions. Most of these infections require aggressive medical treatment and sometimes interventional imaging-guided procedures or surgery...

In general, diabetic patients have an increased risk for gas-forming abdominal infections. Abdomino-pelvic emphysematous pathologies share similar imaging characteristics, as they manifest as acute necrotizing gas-forming infections due to involved bacteria, most often Escerichia coli although it is also associated with Klebsiella pneumoniae, Enterobacter aerogenes, Pseudomonas sp, Proteus Mirabilis and fungi. EMPHYSEMATOUS HEPATITIS The term emphysematous hepatitis (EH) was first described by Blachar et al (1) and the postmortem studies of 2 patients by López Zárraga et al (2). Imaging characteristics and a fulminant clincal...

Acute emphysematous abdomino-pelvic infections represent potentially life-threatening conditions that require aggressive medical and often interventional imaging-guided procedures or surgery to evacuate the purulent content. An appropriate radiologic evaluation combined with an accurate interpretation of findings will enhance treatment effectiveness and improve patient outcomes.

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