Abstract
Objective: The aim of this study was to establish ultrasound as first choice of investigation and protocol in patients with ureteric colic. Methods: We performed ultrasound in 1950 patients with acute ureteric colic and evaluated their urinary tract. More emphasis was given on the evaluation of ureters because during acute ureteric colic, the majority of calculi are present in ureters, and secondly, ureters are difficult to appreciate. For ureters’ appreciation, ultrasonologist ureteric eyeballing expertise is necessary. This skill can be developed by practicing to appreciate the ureteric tract and some landmarks in each and every kind of patient irrespective of ureteric colic. The patient should have a full bladder. Sometimes, good bowel preparation is needed. Results: Of a total of 1950 patients, we detected calculi in 1646 (84.4%) patients by ultrasonography. Calculi were present in ureters in 1580 (81.02%) cases, and the remaining 66 (3.39%) calculi were present in other parts of the urinary tract, i.e., kidneys, urinary bladder, and uretha. Of the remaining 304 (15.58%) cases, where ultrasound study was negative, further in 175 cases, abdominal plain radiography was done, and in 72 (41.14%) cases calculi were detected. The majority of calculi were present in the middle ureter. In 7 cases, where ultrasound and radiography were negative and inconclusive, CT was also performed, but only in two cases, very small (2–4) calculi were detected. However, this CT diagnosis did not change the management. IVU was not done in any cases. Most of the undiagnosed patients responded well on conservative management. A pictorial presentation will be discussed. Conclusions: In the diagnosis and management of patients with ureteric colic, ultrasound should be the first choice of investigation. In inconclusive studies, abdominal plain radiography and very occasionally CT can be performed. Most of the patients responded well on conservative management.
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