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Invited Commentary • Authors' Response

Department of Radiology, Winthrop-University Hospital, Mineola, New York School of Medicine, State University of New York at Stony Brook

Michael J. Lane, MD

South Texas Radiology Group, San Antonio, Texas

Evan M. Meiner, MD

Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York

View larger version (141K): [in a new window]   Figure 1.  Diverticulitis in a 42-year-old man with left flank pain. Unenhanced CT scan shows hyperattenuating material within a diverticulum that extends from the distal descending colon (arrow), with inflammatory changes in the adjacent fat. The left kidney was normal, and there was no ureteral stone.

View larger version (151K): [in a new window]   Figure 2a.  Pancreatitis in a 30-year-old man with left flank pain. Unenhanced CT scans show swelling of the pancreatic body and tail (large arrows in a) and inflammation in the peripancreatic fat (small arrows in a, solid arrows in b). There is also fluid in the left paracolic gutter (open arrow in b).

View larger version (151K): [in a new window]   Figure 2b.  Pancreatitis in a 30-year-old man with left flank pain. Unenhanced CT scans show swelling of the pancreatic body and tail (large arrows in a) and inflammation in the peripancreatic fat (small arrows in a, solid arrows in b). There is also fluid in the left paracolic gutter (open arrow in b).

View larger version (135K): [in a new window]   Figure 3a.  Ruptured abdominal aortic aneurysm in a 76-year-old man with left flank pain. Unenhanced CT scan shows a "crescent sign" along the anterior aspect of the wall of an aneurysm (straight arrows) and left retroperitoneal hemorrhage (curved arrows). (Case courtesy of Gordon V. Smith, MD, Montgomery, Ala.)

View larger version (129K): [in a new window]   Figure 3b.  Ruptured abdominal aortic aneurysm in a 76-year-old man with left flank pain. Unenhanced CT scan shows a "crescent sign" along the anterior aspect of the wall of an aneurysm (straight arrows) and left retroperitoneal hemorrhage (curved arrows). (Case courtesy of Gordon V. Smith, MD, Montgomery, Ala.)

View larger version (129K): [in a new window]   Figure 4a.  Rectal cancer in a 70-year-old man with right lower flank pain. (a, b) Unenhanced CT scans show an oblong mass that invades the right seminal vesicle (arrow in a) and the prostate (thin arrow in b). The mass is contiguous with the rectum (thick arrow in b) and proved to represent rectal cancer at biopsy. (c) Unenhanced CT scan shows renal calcifications and cysts but no right ureteral stone.

View larger version (133K): [in a new window]   Figure 4b.  Rectal cancer in a 70-year-old man with right lower flank pain. (a, b) Unenhanced CT scans show an oblong mass that invades the right seminal vesicle (arrow in a) and the prostate (thin arrow in b). The mass is contiguous with the rectum (thick arrow in b) and proved to represent rectal cancer at biopsy. (c) Unenhanced CT scan shows renal calcifications and cysts but no right ureteral stone.

View larger version (150K): [in a new window]   Figure 4c.  Rectal cancer in a 70-year-old man with right lower flank pain. (a, b) Unenhanced CT scans show an oblong mass that invades the right seminal vesicle (arrow in a) and the prostate (thin arrow in b). The mass is contiguous with the rectum (thick arrow in b) and proved to represent rectal cancer at biopsy. (c) Unenhanced CT scan shows renal calcifications and cysts but no right ureteral stone.

View larger version (153K): [in a new window]   Figure 5a.  Hernia with edema and hemorrhage in a 74-year-old man with suspected right renal colic. Unenhanced CT scans show torsion of a right mesenteric hernia that extends into the right inguinal region (solid arrows in b, arrows in c), edema in the mesentery more superiorly at the level of the middle to lower poles of the kidneys (arrows in a), and hemorrhage in the small bowel mesentery (open arrows in b). The patient did well after undergoing emergency surgery.

View larger version (154K): [in a new window]   Figure 5b.  Hernia with edema and hemorrhage in a 74-year-old man with suspected right renal colic. Unenhanced CT scans show torsion of a right mesenteric hernia that extends into the right inguinal region (solid arrows in b, arrows in c), edema in the mesentery more superiorly at the level of the middle to lower poles of the kidneys (arrows in a), and hemorrhage in the small bowel mesentery (open arrows in b). The patient did well after undergoing emergency surgery.

View larger version (150K): [in a new window]   Figure 5c.  Hernia with edema and hemorrhage in a 74-year-old man with suspected right renal colic. Unenhanced CT scans show torsion of a right mesenteric hernia that extends into the right inguinal region (solid arrows in b, arrows in c), edema in the mesentery more superiorly at the level of the middle to lower poles of the kidneys (arrows in a), and hemorrhage in the small bowel mesentery (open arrows in b). The patient did well after undergoing emergency surgery.