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Work up for acute right lower quadrant pain.
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Multiple small diverticula are seen at the distal of the colon accompanied by short segment increased wall thickness at the sigmoid colon, surrounded by fat stranding, most consistent with acute diverticulitis. The diseased segment of the sigmoid colon is located at the right side of the pelvis due to dolichocolon.
Smudging of the fat planes is seen surrounding the superior mesenteric vessels and their branches within the root of the small bowel mesentery, accompanied by several prominent mesenteric lymph nodes, most compatible with mesenteric panniculitis.
The right kidney is not seen at the anatomical location, and the left shows compensatory hypertrophy. Several simple cortical cysts are present in the left kidney.
A 23 mm fat density mass at the right adrenal gland could be suggestive of lipoma or myelolipoma.
The prostate gland is enlarged.
Degenerative changes such as osteophytosis are seen in the lumbar spine.
Evidence of CD insertion is present at L4 and L5 levels.
Fat containing left inguinal hernia is seen.
In an 80 years old male patient with acute RLQ pain, features on CT are compatible with acute diverticulitis, and due to the dolichocolon, the diseased segment of the sigmoid colon located at the right side of the pelvis.