What imaging is recommended to investigate a patient with brown-colored urine and pneumaturia?

In a patient presenting with brown-colored urine and pneumaturia, the recommended imaging approach focuses on identifying underlying causes that may include urinary tract deviation or fistulas, as well as assessing any potential abdominal pathology.

A CT scan of the abdomen and pelvis is particularly useful because it provides detailed cross-sectional images, allowing for visualization of the urinary tract, potential sources of bleeding, and any abnormalities such as abscesses, tumors, or vesicorectal or vesicovaginal fistulas that could cause pneumaturia (the presence of gas in the urine). This imaging modality can also evaluate for signs of infection or inflammatory conditions, guiding further management effectively.

Other imaging options, such as chest X-ray (CXR), abdominal X-ray (AXR), ultrasound of the abdomen, or plain X-ray of the abdomen, provide less comprehensive assessments. While an ultrasound can evaluate certain conditions, it may not give as complete a picture of the urinary tract as a CT scan. Similarly, CXR and AXR are more limited in their diagnostic capabilities regarding the urinary system and may miss crucial findings that a CT could clarify.

Therefore, the appropriate imaging study in this scenario is a CT scan of the abdomen and pelvis, as it enables thorough evaluation of the underlying