Genitourinary tract gas: imaging evaluation

Area of Science:

• Radiology
• Genitourinary Medicine
• Infectious Diseases

Background:

• Gas-forming infections of the genitourinary tract represent life-threatening emergencies.
• Early and accurate diagnosis is critical for effective medical and surgical management.
• Radiologic interpretation is essential for identifying gas location within the renal parenchyma, collecting system, bladder, uterus, and scrotum.

Purpose of the Study:

• To review the radiologic findings associated with gas in the genitourinary tract.
• To differentiate between various causes of gas formation in different genitourinary organs.
• To emphasize the importance of accurate diagnosis for guiding treatment.

Main Methods:

• Review of radiologic studies including plain radiography, tomography, ultrasonography, urography, barium enema, and computed tomography.
• Correlation of imaging findings with clinical presentation and outcomes.
• Discussion of differential diagnoses for gas in the genitourinary system.

Main Results:

• Three entities associated with renal/perirenal gas: emphysematous pyelonephritis, emphysematous pyelitis, and gas-forming perirenal abscess.
• Bladder gas can result from emphysematous cystitis or vesicoenteric fistula, distinct from instrumentation-induced air.
• Uterine gas suggests infection or neoplasm; scrotal gas indicates infection or bowel herniation.

Conclusions:

• Accurate localization of genitourinary gas via imaging is crucial before treatment.
• Plain radiography and ultrasonography are useful screening tools.
• Computed tomography is often the definitive diagnostic modality for genitourinary gas-forming infections.