Alternative diagnoses to stone disease on unenhanced CT to investigate acute flank pain (original) (raw)
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CT evaluation of flank pain and suspected urolithiasis
Radiologic …, 2009
Background Acute renal colic is the most common clinical indication among patients seen in emergency departments. Studies have shown that 2% to 3% of people will experience an episode of acute renal colic during their lifetime. Objective The objective of this study was ...
Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography
Radiology, 1995
To compare non-contrast-enhanced computed tomography (CT) and intravenous urography (IVU) in the evaluation of patients who present with acute flank pain and in whom ureteric obstruction is suspected. The findings at non-contrast-enhanced CT and IVU in 20 patients with acute flank pain were compared for the presence or absence of ureteric obstruction and delineation of ureteric stones. Twelve of the 20 patients had non-contrast-enhanced CT and IVU findings consistent with ureteric obstruction. Of these 12 patients, five had a ureteric stone that was demonstrated on both non-contrast-enhanced CT scans and IVU radiographs, six had a stone that was depicted on non-contrast-enhanced CT scans only, and in one patient a stone could not be delineated definitively on either non-contrast-enhanced CT scans or IVU radiographs. Eight patients had findings at non-contrast-enhanced CT and IVU consistent with the absence of obstruction. Non-contrast-enhanced CT is more effective than IVU in precis...
2000
Objective: The advantages of non-contrast spiral computerized tomography (CT) were its accuracy and speed, no need for intravenously or orally administered contrast material and ability to detect extra-urinary system in the evaluation of acute flank pain. We assessed the use of spiral CT in-patients with acute flank pain and in patients with ureterolithiasis for prediction of a favorable clinical outcome. Methods: One hundred and eighty five patients having acute flank pain were evaluated with physical examination, urinalysis and hemogram, and non-contrast spiral CT. Stone size (greatest width-mm.), its localization, perinephritic fat stranding, the degree of hydronephrosis, tissue rim sign and perinephritic fluid were assessed on spiral CT. Extracorporeal shock wave lithotripsy (ESWL), surgical approaches, ureteroscopic stone extraction and conservative treatment were performed as therapeutic alternatives in urinary tract stone disease. Results: Urinary stone disease was determined...
Acute flank pain: A modern approach to diagnosis and management
Seminars in Ultrasound, CT and MRI, 1999
Acute flank pain is a common and complex clinical problem. In addition to flank pain caused by ureterolithiasis, other urinary and extraurinary abnormalities can result in a similar clinical picture. Unenhanced CT can rapidly, accurately, and safely determine the presence or absence of ureteral obstruction. When obstruction is caused by ureterolithiasis, CT allows precise determination of stone size and location. These are the two most important factors used for patient management. In addition to direct stone visualization, there are many secondary CT signs of ureteral obstruction that are direct manifestations of the underlying pathophysiology. On the other hand, when obstruction is absent, CT can diagnose or exclude most other abnormalities that result in flank pain. As a result of its many advantages, unenhanced helical CT should become the dominant imaging modality for evaluation of all patients with acute flank pain in whom a clinical diagnosis is uncertain.
JOURNAL OF PEOPLES UNIVERSITY OF MEDICAL AND HEALTH SCIENCES FOR WOMEN (JPUMHS), 2023
BACKGROUND: Urolithiasis is the most common urinary tract disease and acute flank's pain is one of the most common symptoms of it. Urolithiasis affects both gender of all age groups but most common affected category was found to be the male. Computed Tomography is a gold standard modality and has great role for urolithiasis detection during KUB (Kidney, Ureter, Bladder) scan. The objectives of this study were to evaluate the role of Computed Tomography KUB (Kidney, Ureter, Bladder) in the detection of Urolithiasis in patients with acute flank's pain and to identify the presence of renal tract calculi in KUB (Kidney, Ureter, Bladder) to confirm that which part is more affected due to calculus presences. METHOD: A cross sectional study with consecutive sampling was carried out at Department of Radiology, Medical Teaching Institute Hayatabad Medical Complex Peshawar, Pakistan from October 2022 to March 2023. 150 patients aged between 20-60 years presenting with acute flank's pain were included in the study. Ethical approval was obtained. CT KUB of the patient was performed with 128 slices GE Computed Tomography (CT) scan machine on full urinary bladder in supine position 1 cm above the liver through symphysis pubis, used scan parameters technique 120 kV/Auto mA, 0.5 rotation with Standard Algorithm, 4 mm slice thickness and was taken field of view (FOV) according to the patient size. Axial, coronal and sagittal images are taken and soft-tissue window with 2 mm coronal and sagittal was also reconstructed. RESULTS: In total 150 patients presenting with acute flank's pain, 273 stones were detected during CT KUB. The highest number of patients referred by Urologist (60.7%) followed by ER Physician (39.3%). Stones lie in renal calyx (32.7%), renal pelvis (36.7%) and ureter (30.7%). The presence of stones is higher in right kidney (51.4%) as compare to left kidney (38.6%) whereas in right ureter found more stones (17.9%) as compare to left ureter (14.7%). Obstructive Nephrolithiasis was reported to be (27.3%) and non-obstructive (72.7%). According to stone size, majority belongs to 6-10 mm (36.7%). The range of mean attenuation value (HU) was from 301-600 HU having (42.2%) and in most cases single stone were reported (51.3%). Hydronephrosis (65.3%) were the most common secondary signs of obstruction followed by Hydroureter (26.7%) and Perinephric stranding (23.4%). CONCLUSION: Computed Tomography KUB (Kidney, Ureter, Bladder) has main role and is key for detection and diagnosis of Urolithiasis. It helps to provide detail information for further treatment plans.