GENITOURINARY TRACT GAS - IMAGING EVALUATION

Gas-forming infections of the genitourinary tract may manifest as life -threatening conditions, often requiring aggressive medical and surgic al management, Accurate interpretation of the radiologic studies is es sential for early and accurate diagnosis of gas within the renal paren chyma or collecting system, bladder, uterus, and scrotum, Three distin ct entities are associated with renal or perirenal gas: emphysematous pyelonephritis, emphysematous pyelitis, and gas-forming perirenal absc ess, Gas in the bladder may occur secondary to emphysematous cystitis or a vesicoenteric fistula and must be differentiated from air introdu ced by means of instrumentation, Uterine gas usually indicates an unde rlying infection or a neoplasm, Gas II the scrotum is most commonly du e to an infectious process or bowel herniation into the scrotal sac, B efore institution of a specific therapeutic regimen, an effort should be made to establish the exact location of gas in the genitourinary tr act. Plain radiography, including tomography, and ultrasonography are useful screening modalities, Although in some cases urography, barium enema studies, and other contrast material-enhanced studies enable a d iagnosis to be made, in many patients computed tomography is the defin itive diagnostic technique.