Vaginal shape at resting pelvic MRI: predictor of pelvic floor weakness?

Objective: The objective was to determine if alteration in vaginal shape seen on nonstraining pelvic magnetic resonance (MR) scans is associated with pelvic floor weakness.

Methods: Two readers classified the shape of the middle third of the vagina on resting T2-weighted axial images as normal or abnormal for 76 women with and without pelvic floor weakness.

Results: The sensitivity and specificity for diagnosing pelvic floor dysfunction were 84% and 68% for reader A and 41% and 91% for reader B.

Pneumatosis intestinalis: not always a surgical indication.

We present a case of pneumatosis intestinalis (PI) of the colon in the setting of inflammatory bowel disease that was treated with medical management rather than emergent surgery. While the reflex response to extraluminal air in the abdomen is abdominal exploration, consideration of the clinical context in which PI is discovered and an understanding of a complete differential diagnosis of the sources of PI is critical to avoiding unnecessary surgery.