Ectopic gas.

Congress:

ECR 2020

Poster Number:

C-08377

Type:

Educational Exhibit

Keywords:

Not applicable, Acute, Education, CT, Conventional radiography, Emergency, Emergency Imaging

Authors:

S. G. Rizzo, M. Luque, M. ÁLVAREZ GARCÍA, M. Hernandez Herrero, J. Gomez Corral, M. Alonso, S. Marzoa Ruiz, M. Fajardo, M. Mendo; Valladolid/ES

DOI:

10.26044/ecr2020/C-08377

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-08377

Fig. 1: Abdominal enhanced CT shows the left kidney enlarged, without lithiasis or...

Fig. 2: Abdominopelvic enhanced CT scan showed a thickened, enlarged uterus with liquid...

Fig. 3: Abdominal enhanced CT scan showed a distended gallbladder with intramural and...

Fig. 4: Enhanced CT scan showed (fig. 4A) peripancreatic collection with gas (arrow)....

Learning objectives

To describe some pathologies where ectopic gas is the radiological sign for the diagnosis.

Background

Ectopic gas is a frequent finding in the usual radiological practice, being fundamental for the radiologist to be familiar with its leading causes, such as infections, inflammation, neoplasms, iatrogeny and spontaneous etiologies. This series of cases aims to describe and make a clinical-radiological correlation of the main pathologies in which the finding of ectopic gas helps us to establish a diagnostic impression.

Findings and procedure details

Case 1: 78-year-old woman. She presented to the emergency department with general malaise and fever with low back pain. They requested an abdominal CT, with the suspicion of urinary sepsis (fig. 1).Whit de diagnosis of emphysematous pyelonephritis the patient underwent a left radical nephrectomy with subsequent recovery. Emphysematous pyelonephritis is a severe infection with a high morbimortality rate and is characterized by the peculiar formation of gas in or around the kidney. It is more common in women than men and in poorly controlled diabetic...

Conclusion

As it is a frequent image finding, the radiologist has to be familiar with the range of ectopic gas etiologies to arrive at a timely diagnosis.

Personal information and conflict of interest

S. G. Rizzo; Valladolid/ES - nothing to disclose M. Luque; Valladolid/ES - nothing to disclose M. Álvarez García; Valladolid/ES - nothing to disclose M. Mendo; Valladolid/ES - nothing to disclose M. D. L. O. Hernández Herrero; Valladolid/ES - nothing to disclose J. Gómez Corral; Valladolid/ES - nothing to disclose M. Alonso Lacabe; Valladolid/ES - nothing to disclose M. Fajardo; Valladolid/ES - nothing to disclose S. Marzoa Ruiz; Valladolid/ES - nothing to disclose

References

1) Grayson D, Abbott R, Levy A, Sherman P (2002). Emphysematous infections of the abdomen and pelvis: a pictorial review. Radiographics 22: 543-561. 2) Frias A, Reis A, Vidal I. The anatomical compartments and their connections as demonstrated by ectopic air. Insights into Imaging 4, 759-772 (2013). 3) Kanasaki S, Furukama A, Fumoto K, et al. Acute Mesenteric ischemia: Multidetector CT Findings and Endovascular Management. Radiographics 2018; 38:945-961. 4) Pina Polat, MD, Mercit Kantarci, Fatih Alper, Selami Suma, Melike Bedel, et al. Hydatid Disease from...