I couldn't resist posting this unusual scan I performed recently. It happens to be a friend of mine but identity isn't important. What started out as right flank pain became so severe that "Bob" came to my Emergency Room.
A routine CT Abdomen&Pelvis and Renal Ultrasound showed nothing other than a right renal cyst on the inferior pole. The patient was discharged home only to return later that night (on my shift) with increased pain. Evaluation of a second set of bloodwork showed a marked increase in white blood cells so the ER Physician decided to order a second CT Abdomen&Pelvis but with IV and PO contrast dye this time.
The image attached to this blog post shows a fully enhanced left kidney (its on the right side of the screen) and a poorly enhanced right kidney. The right kidney appears to only be receiving contrast dye in the upper and lower poles. The middle pole is almost non-existent.
With these images, the medical team was able to discern a renal infart or possible discection was in play and "Bob" was taken to the Cath Lab for stenting. He is doing much better now, one week later, and is schedule for more follow up testing to check perfusion rates.
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