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Emphysematous conditions of the abdomen and pelvis: pearls and pitfalls
Journal article   Open access   Peer reviewed

Emphysematous conditions of the abdomen and pelvis: pearls and pitfalls

Ananya Panda, Mohamad Kayali and Yashant Aswani
Abdominal radiology (New York), Vol.51(1), pp.483-512
01/2026
DOI: 10.1007/s00261-025-04997-7
PMCID: PMC12830503
PMID: 40576665
url
https://doi.org/10.1007/s00261-025-04997-7View
Published (Version of record) Open Access

Abstract

Emphysematous conditions of the abdomen and pelvis are uncommon but are potentially lethal. A majority of these share common predisposing risk factors such as uncontrolled diabetes mellitus, immunocompromised states, chronic kidney disease, hepatic cirrhosis, malignancy, chemotherapy, and polytrauma. Computed tomography is the most utilized modality for the evaluation of emphysematous conditions in an emergency scenario. It is equally important to recognize mimics of the lethal emphysematous pathologies to avoid misdiagnosis. Gas-containing imaging mimics occur due to recent interventions, instrumentation, and fistulae. This review discusses the pertinent clinical and imaging features of emphysematous conditions of the abdomen and pelvis that can help confirm the diagnosis and guide patient management. For each of these emphysematous pathologies, we also discuss various gas-containing imaging mimics, as the management of these mimics differs from true emphysematous pathologies.
Gas Emphysematous infections Computed tomography Diabetes complications Imaging UIOWA OA Agreement

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