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Pneumopyleviography
Last reviewed: 19.11.2021
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Pneumopyelviography (gynecography, gas pelviography, PPG) is the introduction of gas into the abdominal cavity with the subsequent radiographic examination of the pelvic organs. The method is being replaced by laparoscopy and ultrasound.
Indications: suspicion of developmental abnormalities or swelling of internal genitalia (aplasia of the uterus, gonadal dysgenesis, syndrome of sclerocystic ovaries).
Contraindications: heart failure, hypertension, purulent-inflammatory processes in the abdominal cavity.
The method of gas pelviography consists of two stages: the preparatory (introduction of gas into the abdominal cavity) and the final (X-ray).
Preliminary preparation of the patient is carried out: within three days, a diet with a restriction of carbohydrates and fiber, a reception of activated charcoal, on the evening before and on the morning of the day of the study, a cleansing enema is prescribed.
To create a pneumoperitoneum, use atmospheric air, oxygen, carbon dioxide, nitrous oxide. The use of nitrous oxide and carbon dioxide has certain advantages, as they dissipate faster, which reduces the potential for gas embolism. Usually, the amount of gas introduced does not exceed 2000 ml.
After the creation of pneumoperitoneum, the patient on a gurney is taken to the X-ray room and placed in a Trendelenburg position. In this case, the gas accumulates in the cavity of the small pelvis, and the loops of the intestine leave it.
The uterus with pneumopsychography looks like a dense oval shadow, the lower part of which is more intense than the upper one due to the layering of the neck shade, the shadows corresponding to round and wide bundles and fallopian tubes leave the uterus. The ovaries are defined as dense oval shadows, amounting to approximately 1/3 of the uterine shadow, and are located near the walls of the small pelvis.