Abstract
A 55-year-old man attended A&E complaining of right-sided loin and flank pain of 36 h duration that had recently begun to radiate to the right groin. Observations revealed sepsis and microscopic haematuria, while examination confirmed tenderness in the areas mentioned above. Surprisingly, however, subcutaneous emphysema was also noted, specifically in the right groin and hemiscrotum. The patient was resuscitated successfully with fluids and antibiotics and subsequently underwent emergency unenhanced helical CT (UHCT), the first-line investigation for cases of suspected renal stone disease in our institution. What is your differential diagnosis? What is the diagnosis shown on the UHCT performed in our institution? What radiological investigation(s) would you have chosen?
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