Multidetector CT (MDCT) cystography combines the established technique of excretory cystography with the high spatial resolution of MDCT. MDCT cystography with the use of vaginal tampon helps in increasing the sensitivity and specificity of detecting the presence or absence of urogenital fistulas. Vaginal tampons act as both negative and positive contrast agents. Until recently, urogenital fistulas were investigated by excretory urography/intravenous urography, retrograde ureterography, or retrograde voiding cystography/micturating urography. Scintigraphy with 99mTc diethylenetriaminepentaacetic acid has also been used to help elucidate these pathologic abnormalities. All these modalities are useful in the detection of obvious fistulous tracts but are deficient in providing anatomic detail and have a low specificity.

The renal vasculature and its various congenital anomalies have been studied and documented widely in the literature. However, the concomitant occurrence of renovascular morphological anomalies with vascular compression phenomena in a single patient is a rarity. This is a case of a patient with double left renal arteries, preaortic, accessory and retroaortic left renal veins. There was also associated with vascular compression phenomena in the form of posterior nutcracker phenomenon and pelviureteric junction obstruction (PUJ) due to the double-crossing inferior left polar renal artery and retroaortic vein.

This is a rare case of a patient simultaneously presenting with five complications associated with the prolonged (5 years) use of combined oral contraceptives. The two main ingredients of combined oral contraceptives responsible for thromboembolism are estrogen (estradiol) and progestogen (progestin). Progestins are linked with occlusion of arteries while estrogens can induce both arterial and venous thrombosis. This case represents a patient with portal vein thrombosis, superior mesenteric vein thrombosis, coeliac artery occlusion, splenic and jejunal infarction and focal nodular hyperplasia.