Acute colonic diverticulitis (ACD) is the most common complication of diverticular disease and represents an abdominal emergency. It includes a variety of conditions, extending from localized diverticular inflammation to fecal peritonitis, hence the importance of an accurate diagnosis. Contrast-enhanced computed tomography (CE-CT) plays a pivotal role in the diagnosis due to its high sensitivity, specificity, accuracy, and interobserver agreement. In fact, CE-CT allows alternative diagnoses to be excluded, the inflamed diverticulum to be localized, and complications to be identified. Imaging findings have been reviewed, dividing them into bowel and extra-intestinal wall findings. Moreover, CE-CT allows staging of the disease; the most used classifications of ACD severity are Hinchey’s modified and WSES classifications. Differential diagnoses include colon carcinoma, epiploic appendagitis, ischemic colitis, appendicitis, infectious enterocolitis, and inflammatory bowel disease. We propose a structured reporting template to standardize the terminology and improve communication between specialists involved in patient care.

The term congenital lung malformation (CLM) is used to describe a wide range of pathological conditions with different imaging and clinical manifestations. These anomalies stem from abnormal embryological lung development, potentially occurring across various stages of prenatal life. Their natural history can be variable, presenting in a wide range of severity levels and encompassing asymptomatic individuals who remain so until adulthood, as well as those who experience respiratory distress in the neonatal period. Through the PubMed database, we performed an extensive review of the literature in the fields of congenital lung abnormalities, including their diagnostic approach and findings. From our RIS-PACS database, we have selected cases with a final diagnosis of congenital lung malformation. Different diagnostic approaches have been selected, including clinical cases studied using plain radiograph, CT scan, prenatal ultrasound, and MR images. The most encountered anomalies can be classified into three categories: bronchopulmonary anomalies (congenital pulmonary airway malformations (CPAMs), congenital lobar hyperinflation, bronchial atresia, and bronchogenic cysts), vascular anomalies (arteriovenous malformation), and combined lung and vascular anomalies (scimitar syndrome and bronchopulmonary sequestration). CLM causes significant morbidity and mortality; therefore, the recognition of these abnormalities is necessary for optimal prenatal counseling and early peri- and postnatal management. This pictorial review aims to report relevant imaging findings in order to offer some clues for differential diagnosis both for radiologists and pediatric consultants.

Background/Objectives: To provide an updated overview of adrenal incidentaloma evaluation, characterize the principal imaging mimics across pediatric and adult populations, and propose a clinically actionable approach integrating endocrine assessment with conventional and advanced imaging. Methods: A narrative review of recent evidence and major international recommendations was performed, focusing on epidemiology, endocrine work-up, non-contrast computed tomography (CT), washout CT, magnetic resonance imaging (MRI), and dual-energy CT (DECT). Results: The recent literature has questioned a uniformly washout-centered approach and has raised interest in more selective, risk-adapted strategies based on clinical context, endocrine profile, and lesion phenotype; however, these proposals should be distinguished from established guideline recommendations. Non-contrast CT remains the cornerstone of first-line characterization, particularly for identifying lipid-rich adenomas. However, the routine use of adrenal washout CT is increasingly questioned, especially in true incidentalomas, because many benign adenomas are lipid-poor and several non-adenomatous lesions may show overlapping washout behavior. In this setting, MRI maintains a key problem-solving role, mainly through chemical shift imaging. DECT represents the most promising technical advance, enabling multiparametric characterization through virtual non-contrast images, iodine quantification, and material decomposition, with the potential to improve the assessment of indeterminate lesions while reducing unnecessary multiphasic imaging and radiation exposure. Conclusions: Current management should remain grounded in established guideline recommendations. MRI may be selectively used as a problem-solving modality, while DECT and emerging strategies require further validation before they can be considered standards of care.

Intestinal volvulus is a pathological condition that can lead to bowel obstruction and intestinal ischemia, and is therefore potentially fatal in severe cases. Patients' symptoms are often nonspecific: volvulus most frequently presents as an acute abdomen, but vague symptoms such as abdominal pain and distension, nausea and vomiting are common. In this scenario, the gold standard for diagnosis is contrast-enhanced computed tomography, which allows a timely assessment. However, in this article we present a rare case of a small bowel volvulus associated with a sigmoid volvulus in which the patient presented to the emergency department with respiratory symptoms.