Joseph R C, Amendola M A, Artze M E, Casillas J, Jafri S Z, Dickson P R, Morillo G
Department of Radiology, University of Miami School of Medicine, Jackson Memorial Medical Center, FL 33136, USA.
Radiographics. 1996 Mar;16(2):295-308. doi: 10.1148/radiographics.16.2.8966288.
Gas-forming infections of the genitourinary tract may manifest as life-threatening conditions, often requiring aggressive medical and surgical management. Accurate interpretation of the radiologic studies is essential for early and accurate diagnosis of gas within the renal parenchyma or collecting system, bladder, uterus, and scrotum. Three distinct entities are associated with renal or perirenal gas: emphysematous pyelonephritis, emphysematous pyelitis, and gas-forming perirenal abscess. Gas in the bladder may occur secondary to emphysematous cystitis or a vesicoenteric fistula and must be differentiated from air introduced by means of instrumentation. Uterine gas usually indicates an underlying infection or a neoplasm. Gas in the scrotum is most commonly due to an infectious process or bowel herniation into the scrotal sac. Before institution of a specific therapeutic regimen, an effort should be made to establish the exact location of gas in the genitourinary tract. 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 diagnosis to be made, in many patients computed tomography is the definitive diagnostic technique.
泌尿生殖道产气感染可能表现为危及生命的情况，通常需要积极的内科和外科治疗。准确解读影像学检查对于早期准确诊断肾实质、集合系统、膀胱、子宫和阴囊内的气体至关重要。有三种不同的情况与肾内或肾周气体有关：气肿性肾盂肾炎、气肿性肾盂炎和气性肾周脓肿。膀胱内的气体可能继发于气肿性膀胱炎或膀胱肠瘘，必须与器械操作引入的空气相鉴别。子宫内气体通常提示潜在感染或肿瘤。阴囊内的气体最常见于感染性病变或肠管疝入阴囊。在制定具体治疗方案之前，应努力确定泌尿生殖道内气体的确切位置。普通X线摄影，包括体层摄影和超声检查，是有用的筛查方式。虽然在某些情况下，尿路造影、钡剂灌肠检查和其他对比剂增强检查能够做出诊断，但在许多患者中，计算机断层扫描是决定性的诊断技术。
