ARRS 2022 Abstracts

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E1914. Gasogram: Appearance of Gaseous Pathology on Ultrasound
Authors
  1. Yonatan Rotman; University of Rochester
  2. Irianna Torres; University of Rochester
  3. Mark Manganaro; University of Rochester
  4. Akshya Gupta; University of Rochester
  5. Vikram Dogra; University of Rochester
Background
Ultrasound is a commonly used imaging modality and is often the first modality used to evaluate for pathology. Gas is naturally present in the bowel; however, there are various different pathologic entities in which gas can be seen. Gaseous infection is often associated with severe morbidity and mortality, necessitating its prompt recognition and reporting. This exhibit will help residents and the general radiologist become familiar with a few instances when gas is pathologic on ultrasound.

Educational Goals / Teaching Points
The goals of this exhibit are to recognize the appearance of gas on ultrasound and differentiate it from artifact and identify when gas is pathologic and when it is an expected finding. We present a case-based review of the various pathologic entities that may lead to gas formation and correlate ultrasound findings with appearance on other imaging modalities such as CT or MRI.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will highlight examples of pathological air on ultrasound including but not limited to free air, pneumatosis intestinalis, pneumobilia, portal venous gas, emphysematous cholecystitis, pyelonephritis, pyelitis, cystitis, and Fournier's gangrene. Each case will use an additional image modality such as CT or MRI for correlation. Examples of ultrasound artifacts will also be provided to help differentiate and contrast it from gas.

Conclusion
Gas may be an expected finding in ultrasound, but it may also be pathologic; for example, as a severe complication of infection with often profound morbidity and mortality. This makes it crucial to identify gas on ultrasound and know the various entities that may give rise to it.