Evaluation of Spigelian hernia by CT.

Spigelian hernias are uncommon abdominal wall hernias with subtle clinical findings. The CT studies of three cases are reported. All our patients presented with abdominal mass and vague symptoms. The CT evaluation allowed preoperative diagnosis.

Radiographic demonstration of a toxic agent.

The abdominal radiographs obtained on a young man attempting suicide by stabbing revealed an unusual opacity in the true pelvis, confirmed as being due to unsuspected carbon tetrachloride ingestion. This is the first known radiologic demonstration of oral ingestion of a rapidly acting toxic substance.

Radionuclide detection of iatrogenic arteriovenous fistulas of the genitourinary system.

Radionuclide angiography is a valuable screening test for arteriovenous (AV) fistulas. Seven iatrogenic AV communications of the genitourinary system were initially diagnosed by radionuclide imaging, and untreated patients are being followed up by yearly nuclear examinations. Contrast arteriography is reserved for patients requiring interventional therapy and for symptomatic patients with a negative radionuclide study.

The signs of a passed ureteral stone.

Ten patients with typical renal colic fortuitously passed a urinary calculus, which was retrieved during or shortly after excretory urography. Characteristic alterations in the urogram included: (a) no delay in passage of contrast medium down the entire length of the ureter, (b) decreased radiodensity of contrast on the affected as compared to that of the normal side, (c) dilatation of the ureter on the affected side and (d) a hazy appearance of the ureter with poor definition of its borders. Post-obstructive diuresis explains these changes. This constellation of findings, with accompanying absence of an opaque calculus on the plain film, correctly diagnoses a recently passed stone. The sign complex indicates that obstruction has been relieved, even when the calculus remains in situ.