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

Abstract

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 Ozet Amac. Acil servise akut uriner sikayetlerle basvuran hastalarin incelenmesi sirasinda kontrastsiz bilgisayarli tomografi (BT) ile ilgili tecrubelerimizi sunmak amaci ile yan agrisi ile gelen ve supheli uriner tasi olan hastalarin klinik ve kontrastsiz (BT) verilerini degerlendirdik. Yontem. Klinik, kontrastsiz BT ve ultrasonografi (US) incelemeleri 2011 yilinda acil ve radyoloji departmanlarinda yapilan 102 adet eriskin akut uriner tas hastasinda retrospektif olarak degerlendirildi. Bulgular. Degerlendirilen 102 olgunun 95 tanesinde kontrastsiz BT'de tasi mevcuttu. Ultrasonografi kaliks dilatasyonu ve hidronefrozun degerlendirilmesinde yardimci bulgular sagladi. Uriner sistemde uriner taslarin spesifik bolgesi ve seviye tercihi bulunmamaktaydi. Multipl uriner tasi olan hastalarda BUN ve kreatinin seviyeleri tek uriner tasi olan hastalardan daha yuksekti (p<0,05). Tek uriner tas sayisi daha sik oldugu halde tek ve multipl taslarin bobrek, ureter ve mesanede bulunma orani ozellik gostermiyordu. Sonuclar. Bu calismada akut durumlarda Acil servise basvuran hastalarda uriner taslarin tanisi sirasinda kontrastsiz BT'nin etkinligini gostermeyi amacladik. Bizim bulgularimiza gore US ile birlikte kontrastsiz BT Acil serviste uriner tasli hastalar icin tanisal modalitedir. Uriner tasli olgularin klinikoradyolojik tanilari uzerinde onerdigimiz yolun tercih edilmesinin etkilerini aydinlatmak icin daha fazla calismalara ihtiyac vardir. Anahtar sozcukler: Uriner tas, acil servis, non-kontrast bilgisayarli tomografi, ultrasonografi