Scary gas: pathways in the axial body for soft tissue gas dissection (part I)

Gas is often encountered in abnormal locations in the torso, including within soft tissue compartments, vessels, and bones. The clinical significance of this gas ranges from incidental, benign, and self-limited to aggressive infection requiring immediate surgery. As a result of fascial interconnecti...

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Bibliographic Details
Published in:Emergency radiology 2017-10, Vol.24 (5), p.569-576
Main Authors: Sandstrom, Claire K., Osman, Sherif F., Linnau, Ken F.
Format: Article
Language:English
Subjects:
Blood vessels
Bones
Compartments
Diagnosis, Differential
Dissection
Emergency Medicine
Emphysema - diagnostic imaging
Gases
Humans
Imaging
Medicine
Medicine & Public Health
Pictorial Essay
Radiology
Subcutaneous Tissue
Thorax
Thorax - diagnostic imaging
Torso
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Summary:Gas is often encountered in abnormal locations in the torso, including within soft tissue compartments, vessels, and bones. The clinical significance of this gas ranges from incidental, benign, and self-limited to aggressive infection requiring immediate surgery. As a result of fascial interconnectivity and pressure differences between compartments, gas can dissect distant from its source. Gas can easily dissect between spaces of the extrapleural thorax, subperitoneal abdomen, deep cervical spaces, and subcutaneous tissues. The pleural and peritoneal cavities are normally isolated but may communicate with the other spaces in select situations. Dissection of gas may cause confusion as to its origin, potentially delaying treatment or prompting unnecessary and/or distracting workup and therapies. The radiologist might be the first to suggest and identify a remote source of dissecting gas when the clinical manifestation alone might be misleading. The purpose of this paper, the first in a three-part series on soft tissue gas, is to explore the various pathways by which gas dissects through the superficial and deep compartments of the torso.
ISSN:1070-3004
1438-1435
DOI:10.1007/s10140-017-1489-3