Place of non-contrast computed tomography for evaluation of flank pain and suspected urinary stone in emergency service

Abstract

Aim. With an intent to present our experience with the non-contrast computed tomography (CT) during the work-up of patients admitted with acute urinary complaints in the emergency service, we reviewed our clinical and non-contrast CT imaging data of patients presented with flank pain and suspected urinary stone. Methods. Clinical and non-contrast CT with ultrasound examinations performed at our Emergency and Radiology Departments in 2011 were reviewed retrospectively in 102 adult urinary stone patients in acute conditions. Results. In 102 patients with suspected urinary stones, 95 had urinary stones detected with non-contrast CT. Ultrasonography provided helpful findings for the evaluation of calyceal dilatation and hydronephrosis. There was no specific side and level preference of urinary stones in the urinary tract. There was no hydronephrosis in for the percent of urinary stone patients. The BUN and creatinine levels in the patients with multiple urinary stones were higher than those in the patients with single urinary stones (p<0.05). Although single urinary stone was more common, overall there was no specific propensity of single and multiple urinary stones to kidney, ureter, and bladder. Conclusions. In this study, we attempted to reveal the efficacy of non-contrast CT during the diagnosis of urinary stones in patients presenting to the Emergency Department in acute conditions. According to our findings, non-contrast CT with ultrasound is diagnostic modality for patients with urinary stones in the Emergency Department. Further studies are needed to shed light on the long-term effects of the choice of this pathway on the clinicoradiologic diagnosis of urinary stone patients. According to our findings, non-contrast CT with ultrasound is diagnostic modality for patients with urinary stones in the Emergency Department. Further studies are needed to shed light on the long-term effects of the choice of this pathway on the outcome of urinary stone patients. Keywords: Urinary stone, emergency department, non-contrast computed tomography, ultrasonography Özet Amaç. Acil servise akut üriner şikayetlerle başvuran hastaların incelenmesi sırasında kontrastsız bilgisayarlı tomografi (BT) ile ilgili tecrübelerimizi sunmak amacı ile yan ağrısı ile gelen ve şüpheli üriner taşı olan hastaların klinik ve kontrastsız (BT) verilerini değerlendirdik. Yöntem. Klinik, kontrastsız BT ve ultrasonografi (US) incelemeleri 2011 yılında acil ve radyoloji departmanlarında yapılan 102 adet erişkin akut üriner taş hastasında retrospektif olarak değerlendirildi. Bulgular. Değerlendirilen 102 olgunun 95 tanesinde kontrastsız BT'de taşı mevcuttu. Ultrasonografi kaliks dilatasyonu ve hidronefrozun değerlendirilmesinde yardımcı bulgular sağladı. Üriner sistemde üriner taşların spesifik bölgesi ve seviye tercihi bulunmamaktaydı. Multipl üriner taşı olan hastalarda BUN ve kreatinin seviyeleri tek üriner taşı olan hastalardan daha yüksekti (p<0,05). Tek üriner taş sayısı daha sık olduğu halde tek ve multipl taşların böbrek, üreter ve mesa...