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Coronavirus disease 2019 (COVID-19) is mostly perceived as a respiratory disease. However, there is increasing evidence of patients showing gastrointestinal symptoms, with increasing rates of presentation according to the severity of the disease. In a few cases, the abdominal involvement of COVID-19 resulted in spontaneous bowel perforation. Here, we present in detail the first case of rectal perforation in a patient with COVID-19.

Renal colic indicates a type of abdominal pain due to urinary tract obstruction, commonly caused by urinary stones. The classic presentation of renal colic is the sudden onset of severe loin pain, but depending on the site of obstruction, the pain will radiate to the flank, groin, and testes or labia majora. Unfortunately, symptoms due to many other abdominal diseases could be indistinguishable from renal colic, and therefore emergency imaging in patients with suspected renal colic is necessary to rule out other clinical conditions, either renal diseases or gynecologic, gastrointestinal, pancreatic, hepatobiliary, vascular, and musculoskeletal conditions. In this setting, imaging is required to allow rapid diagnosis, to guide patient management, and to evaluate active treatment complications.

The tumors of the upper urinary tract include tumors developing in the renal pelvis and ureter. Transitional cell carcinomas (TCCs) of the renal pelvis or renal calices are relatively rare tumors of the kidney. Multidetector CT urography is currently considered the most sensitive and comprehensive imaging modality for the evaluation of the entire urinary tract and the detection of TCCs. TCCs may manifest as single or multiple discrete filling defects, filling defects within distended calyces, calyceal obliteration (calyceal amputation), hydronephrosis with renal enlargement caused by tumor obstruction of ureteropelvic junction, or as reduced renal function – excluded kidney – without renal enlargement caused by long-standing tumor obstruction of the ureteropelvic junction and atrophy.

Urinary tract obstruction refers to the structural or functional changes in the urinary tract that impede the normal flow of urine and is a clinical situation which may be clearly defined by imaging. The different causes of renal obstruction may be easily detected by ultrasound (US) and characterized, thanks to the panoramicity of the new imaging modality such as computed tomography urography (CTU) and magnetic resonance urography (MRU). Pyonephrosis represents the chronic suppurative infection in an obstructed kidney. Grayscale US with tissue harmonic imaging represents the most sensitive imaging technique to detect pyonephrosis. The vesicoureteral reflux is the retrograde flow of urine from the bladder toward the kidney.

This study assessed means by which to optimise 64-slice computed tomography urography (CTU) in evaluating the urinary tract, with a view to obtaining the best trade-off between image quality and radiation dose.Image quality was analysed in terms of spatial and contrast resolution on several scans of a phantom performed with automatic dose modulation and different reconstruction kernels and accepted noise level. Data were compared with the radiation dose values recorded for 52 patients who underwent CTU examination.Radiation dose and image quality differed considerably depending on the reconstruction parameters, even though a higher dose did not always imply better image definition. Data obtained in the phantom were consistent with those obtained in patients. Depending on the clinical problem, the radiation dose varied from 6.2 to 17.6 mSv.CTU cannot be considered a standard examination: the scan parameters need to be adapted to the image quality required for the specific clinical problem.

Chronic renal infections are becoming increasingly rare because of the availability of effective antibiotics and early detection and treatment of both acute renal and urinary tract infections and conditions predisposing a patient to chronic infections. The aim of the present chapter is to illustrate the fundamental imaging features of the different forms of chronic renal infections and the modern imaging of renal tuberculosis with multidetector CT urography. From pathological point of view, the chronic renal infections include two types, interstitial chronic pyelonephritis and granulomatous pyelonephritis, namely, xanthogranulomatous pyelonephritis, malacoplakia, and renal tuberculosis. In this chapter the findings and the role of ultrasonography (US), computed tomography (CT), intravenous excretory urography, and CT urography in the different chronic renal infections are reviewed.

This study sought to assess the diagnostic accuracy of 64-slice computed tomography urography (CTU) in evaluation of the urinary tract. A total of 322 CTU procedures were carried out in 317 consecutive patients (mean age 64.4 years). The findings were compared with previous and subsequent patient workup considering both laboratory and imaging studies, such as urine cytology, abdominal ultrasound and CT, cystoscopy, retrograde pyelography, surgery and pathology. Out of 322 CTU examinations, 169 showed significant urinary tract changes, whereas 153 revealed no urinary disease, in good agreement with the follow-up. In particular, in bladder evaluation, for which we have a direct comparison with cystoscopy in 125 patients, we calculated a CTU sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 85%, 94%, 92%, 89% and 90%, respectively. CTU was accurate for urinary tract evaluation, but it cannot replace cystoscopy in patients in whom a malignant bladder disease is suspected.

A variety of surgical procedures has been developed to manage different penile pathologies and malformations. Penile surgery produces anatomical and vascular changes that can be successfully investigated with grey scale and color Doppler ultrasonography. In particular, early and late surgical complications can be identified, and postoperative changes of the normal ultrasound appearance of the penile envelopes, of the penile bodies and of flow characteristics in the penile vessels can be investigated.

Magnetic resonance imaging (MRI) has opened new possibilities to current diagnostic radiology in the evaluation of bone marrow. Compared with other imaging modalities, MRI is the only technique able to directly visualise bone marrow with its different components of red and yellow marrow. Other advantages of MRI are high-contrast resolution and multiplanar view, as well as extensive coverage of the skeleton with whole-body MRI (WBMRI). However, specificity of signal alterations of bone marrow is low. Therefore, MRI findings need to be integrated with clinical and laboratory findings as well as with haematological and oncological evaluation. MRI provides information that effectively aids diagnosis, staging and follow-up of various bone marrow disorders. There is increasing interest in the capabilities of MRI in the evaluation of bone marrow, in particular of haematological malignancies. According to some authors much work remains to be done to improve sensitivity and specificity of MRI in order to define the real clinical value of this imaging modality in the multidisciplinary management of patients with a haematological malignancy. This article presents recent developments and perspectives in the use of MRI in oncohaematological diseases.