What you should know about emphysematous vaginitis?

Emphysematous vaginitis represents a rare and self-limited condition, which presents with vaginal discharge. Despite its benignity, it has some worrisome imaging features, which should be recognized in order to avoid unnecessary invasive procedures.

INTRODUCTION

A 27‐year‐old pregnant woman with preeclampsia was admitted for an emergency C‐section which complicated with hemolytic uremic syndrome. She was treated with corticotherapy and after clinical stabilization, the patient complained of vaginal bleeding. At this point, the laboratorial tests did not reveal elevated inflammation parameters. Gynecological examination was normal, but a popping sound was heard.1 The pelvic radiograph (Figure 1) revealed a radiolucent cluster of gas centered at the pubic symphysis, and the pelvic CT (Figure 2) showed multiple gas‐filled cysts in the vaginal wall at the level of the vaginal fornix and an edematous cervix.2 The diagnostic hypothesis was of emphysematous vaginitis, a rare and benign condition, that is considered to be related to Trichomonas vaginalis. The vaginal exudate was normal, so the patient did not receive any treatment.1, 2 She was discharge from the hospital, clinically stable and without any gynecological complaints.

Figure 1

Pelvic radiography: PA view: a radiolucent cluster of gas is seen, which is centered at the pubic symphysis, at the level of the vagina

Figure 2

Pelvic computed tomography: We can see multiple gas‐filled cysts in the vaginal wall at the level of the vaginal fornix, and the edematous cervix is seen extended into the vaginal fornix

CONFLICT OF INTEREST

None declared.

AUTHOR CONTRIBUTIONS

AFBT: conceived the manuscript and involved in the search and elaboration of the manuscript. JCCG: involved in the elaboration and figure management of the manuscript. MFSB: conceived and revised the manuscript.