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Pneumopelviography
Last reviewed: 04.07.2025
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Pneumopelviography (gynecography, gas pelviography, PPG) involves introducing gas into the abdominal cavity followed by X-ray examination of the pelvic organs. The method is currently being replaced by laparoscopy and ultrasound examination.
Indications: suspected developmental abnormalities or tumors of the internal genital organs (uterine aplasia, gonadal dysgenesis, sclerocystic ovary syndrome).
Contraindications: heart failure, hypertension, purulent-inflammatory processes in the abdominal cavity.
The gas pelviography technique consists of two stages: preparatory (introduction of gas into the abdominal cavity) and final (X-ray pelviography).
The patient is prepared in advance: for three days, a diet with limited carbohydrates and fiber is prescribed, as well as activated charcoal, and a cleansing enema is administered in the evening before and in the morning on the day of the examination.
To create pneumoperitoneum, atmospheric air, oxygen, carbon dioxide, and nitrous oxide are used. The use of nitrous oxide and carbon dioxide has certain advantages, as they are absorbed faster, which reduces the potential for gas embolism. Usually, the amount of gas administered does not exceed 2000 ml.
After creating pneumoperitoneum, the patient is taken to the X-ray room on a gurney and placed in the Trendelenburg position. In this case, the gas accumulates in the pelvic cavity, and the intestinal loops leave it.
The uterus in pneumopsulviography has the appearance of a dense oval shadow, the lower part of which is more intense than the upper part due to the layering of the shadow of the cervix, shadows extend from the uterus, corresponding to the round and broad ligaments and fallopian tubes. The ovaries are determined as dense oval shadows, making up approximately 1/3 of the shadow of the uterus, and are located at the walls of the small pelvis.