Learning objectives
The objective of this review is to differentiate the pathologic and non-pathologic causes of ectopic gas in the abdomen and pelvis,
with the aim of optimizing an adequate therapeutic technique in each case whether it implies an aggressive medical and often surgical management or an expectant behaviour.
Background
The presence of gas within the peritoneum,
the parenchyma of solid organs or the walls of hollow viscera may be due to a variety of pathologic or benign entities.
There is a wide variety of clinical conditions which manifest radiologically by the presence of ectopic gas in the abdomen and pelvis and can represent a serious or even life-threatening condition.
The initial clinical manifestation of these entities may be insidious,
but rapid progression to sepsis will occur in the absence of early therapeutic intervention.
Conventional...
Imaging findings OR Procedure details
CAUSES OF PATHOLOGIC ECTOPIC GAS:
• Infection: Tissue infection with gas-forming bacteria (or emphysematous infection) is a very important source of gas that can affect any organ in the abdomen and pelvis either as a diffuse pattern of gas in the wall or the parenchyma of the structure involved,
as a well circumscribed abscess secondary to any infectious process or as presence of gas in the portomesenteric axis (usually as a secondary finding to the main infectious process).
These are severe infections,
most commonly seen...
Conclusion
The radiologist must recognize with prompt,
accurate interpretation of situations in which ectopic gas indicates a serious disease and distinguish them from situations with no pathological significance that require no intervention,
and should be familiar with the specific characteristics of each entity.
References
Joseph RC,
Amendola MA,
Artze ME,
Casillas J,
Jafri SZH,
Dickson PR,
Morillo G.
Genitourinary tract gas: imaging evaluation.
RadioGraphics 1996; 16:295-308.
Grayson DE,
Abbott RM,
Levy AD,
Sherman PM. Emphysematous infections of the abdomen and pelvis: a pictorial review.
RadioGraphics 2002; 22:543–561.
Restrepo CS,
Ocazionez D,
Suri R,
Vargas D. Aortitis: imaging spectrum of the infectious and inflammatory conditions of the aorta.
RadioGraphics 2011; 31:435–451.
Rha SE,
Ha HK,
Lee S-H,
Kim J-H,
Kim JK,
Kim JH,
Kim PN,
Lee M-G,
Auh Y-H. CT...