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Vaginitis Emphysematosa

CT and Review of the Literature

¹ Both authors: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.

View larger version (121K): [in a new window]   Fig. 1A. —29-year-old woman with acute myelogenous leukemia and vaginal bleeding. Digital scout radiograph before pelvic CT shows radiolucent clusters of gas-filled cysts along contours of vaginal wall (arrows). Pattern is similar to that identified with pneumatosis intestinalis.

View larger version (140K): [in a new window]   Fig. 1B. —29-year-old woman with acute myelogenous leukemia and vaginal bleeding. CT scan at level of vaginal fornix shows that radiolucent clusters seen in A correspond to gas-filled cysts in vaginal wall, so-called vaginitis emphysematosa (straight arrows). Note that edematous cervix (C) extends into vaginal fornix. Also note contrast medium in rectum (curved arrow).

View larger version (130K): [in a new window]   Fig. 1C. —29-year-old woman with acute myelogenous leukemia and vaginal bleeding. CT scan shows vaginitis emphysematosa in lower third of vagina (arrows).

View larger version (134K): [in a new window]   Fig. 1D. —29-year-old woman with acute myelogenous leukemia and vaginal bleeding. CT scan at inferiormost aspect of pelvis shows extension of gas to introitus with tiny punctate gas foci in labial folds (arrow).

View larger version (124K): [in a new window]   Fig. 2A. —25-year-old woman with medical history of systemic lupus erythematosus and chronic vaginitis. CT scan at vaginal fornix shows vaginitis emphysematosa. As seen in Figure 1C, edematous cervix appears as soft-tissue mass extending into vaginal fornix. Patient previously underwent internal fixation of right femoral fracture. Note gas in rectum (arrow).

View larger version (90K): [in a new window]   Fig. 2B. —25-year-old woman with medical history of systemic lupus erythematosus and chronic vaginitis. CT scan at wide window setting shows coalescent gas-filled cysts separated by thin walls. Cysts range from 2 to 10 mm.

View larger version (160K): [in a new window]   Fig. 3A. —62-year-old woman with diabetes mellitus and end-stage renal disease. CT scan through lower third of vagina after internal fixation of remote right femoral fracture shows gas in walls of vagina. Note Foley catheter coursing through urethra (arrow).

View larger version (112K): [in a new window]   Fig. 3B. —62-year-old woman with diabetes mellitus and end-stage renal disease. CT scan at wider window setting than A shows that gas is composed of multiple coalescent cysts in vaginal wall (arrows).

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