scholarly journals Ultrasound at the patient’s bedside for the diagnosis and prognostication of a renal colic

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jean-Eudes Bourcier ◽  
Emeric Gallard ◽  
Jean-Philippe Redonnet ◽  
Morgan Abillard ◽  
Quentin Billaut ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Colic ◽  
Ureteral Stones ◽  
Point Of Care Ultrasound ◽  
Diagnostic Strategies ◽  
Ct Examination ◽  
Ambulatory Treatment ◽  
Urinary Tract Dilatation ◽  
Imaging Results ◽  
Ureteral Colic

Abstract Background Diagnosing a ureteral colic is sometimes difficult; however, clinicians should not fail to detect a surgical emergency. This is why diagnostic strategies depend on the imaging examinations, especially ultrasound. Prior studies have investigated the accuracy of Point of Care Ultrasound (PoCUS), but there are relatively few. This study aimed to evaluate the performance of the PoCUS in the diagnosis of renal colic. The secondary objective was to evaluate the relationship between the imaging results and the treatment performed. Methods After the clinical evaluation of patients aged > 18 years with suspected ureteral colic, the Emergency Physician (EP) trained in ultrasound performed PoCUS to conclude whether a diagnosis of “renal colic” should be made. A computed tomography (CT) examination was subsequently performed, to determine whether ureteral or bladder lithiasis was present to diagnose a ureteral colic. The patient’s management was decided according to the to degree of urinary tract dilatation, presence of perinephric fluid, size, and localization of stones. Results Of the 12 Eps in our units, seven met the training criteria for the inclusion of patients. A total of 103 patients were analyzed, and the renal colic diagnosis was retained in 85 cases after the CT examination. The accuracy of PoCUS was 91% (86; 95%) for detecting urinary tract dilatation, 83% (76; 90%) for detecting perinephric fluid, and 54% (44; 64%) for detecting lithiasis. Only high urinary tract stones with ≥ 6 mm diameter were surgically managed (p < 0.01). Conversely, distal ureteral stones with a diameter of < 6 mm were managed with medical ambulatory treatment (p < 0.05). Conclusion PoCUS is a good diagnostic tool, for renal colic, and could help reduce the requirement for the CT examinations and, hence, reduce induced radiation exposure.

Urinary Tract Dilatation and Oral Contraceptives

BMJ ◽  
1971 ◽  
Vol 1 (5742) ◽  
pp. 230-230 ◽  
Author(s):  
P. Dure-Smith
Keyword(s):  
Urinary Tract ◽  
Oral Contraceptives ◽  
Urinary Tract Dilatation

scholarly journals Anuria Secondary to Bilateral Obstructing Ureteral Stones in the Absence of Renal Colic

2016 ◽  
Vol 2 (1) ◽  
pp. 93-95 ◽  
Author(s):  
Carolyn A. Salter ◽  
Christopher Lang ◽  
Hernan O. Altamar
Keyword(s):  
Renal Colic ◽  
Ureteral Stones

scholarly journals Renal colic, where is it headed? An observational study

2016 ◽  
Vol 88 (1) ◽  
pp. 7 ◽  
Author(s):  
Paolo Beltrami ◽  
Andrea Guttilla ◽  
Lorenzo Ruggera ◽  
Patrizia Bernich ◽  
Filiberto Zattoni
Keyword(s):  
Emergency Department ◽  
Urinary Tract ◽  
Observational Study ◽  
Clinical Management ◽  
Renal Colic ◽  
Ureteral Stone ◽  
Ureteral Calculi ◽  
Ureteral Calculus ◽  
Spontaneous Expulsion ◽  
Pain Symptoms

Aim: In the last thirty years, the treatment for renal and ureteral calculi has undergone profound variations. The objective of this study has been to evaluate the existence of parameters which can affect the spontaneous expulsion of a symptomatic ureteral stone in a reasonably brief period of time and to identify whether certain parameters such as sex, age, the location and dimension of the stone, the presence of dilation in the urinary tract together with the administered therapy, can be used for a correct clinical management of the patient. Methods: In a period of 9 months, 486 cases of renal colic were registered at emergency department. Results: The cases of renal colic due to ureteral calculus were 188 (38.7%). The patients’ charts, complete of all data and therefore, valid for this research, resulted to be 120 (64%). In the presence of a symptomatic ureteral stone, the correct approach must first of all, focalize on the dimension of the calculus itself; less importance instead, is given to the location, as reported in other studies, the presence of hydroureteronephrosis, sex and the side. Conclusion: In the cases when the pain symptoms cannot be solved by means of the administration of analgesics, it is then reasonable to take into consideration an immediate endourological treatment. If the pain symptoms are promptly solved, an attentive wait of 4 weeks should be considered reasonable in order to allow spontaneous expulsion of the calculus.

scholarly journals MP10: Does arrival pain severity predict stone characteristics or short-term outcomes in emergency department patients with acute renal colic?

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S45-S46
Author(s):  
G. Splinter ◽  
K. Gourlay ◽  
J. Hayward ◽  
G. Innes
Keyword(s):  
Emergency Department ◽  
Severe Pain ◽  
Renal Colic ◽  
Pain Severity ◽  
Secondary Outcome ◽  
Advanced Imaging ◽  
Stone Size ◽  
Pain Scores ◽  
Imaging Results ◽  
Stone Characteristics

Introduction: Renal colic is among the most painful conditions that patients experience. The main outcome determinants for patients with renal colic are stone size, location and hydronephrosis; however, little is known about the association of pain with these parameters. Our objective was to determine whether more severe pain is associated with larger stones, more proximal stones or more severe hydronephrosis, findings that might suggest the need for advanced imaging, hospitalization or early intervention. Methods: We used administrative data and structured chart review to study all adult emergency department (ED) patients in two cities with a renal colic diagnosis over one-year. Patients with missing imaging results or pain scores were excluded. Triage nurses recorded numeric rating scale (NRS) pain scores on arrival. We stratified patients into mild (NRS <4), moderate (NRS 4-7) and severe (NRS 8-10) pain groups, as per CTAS guidelines. Stone size (mm) and location (proximal, middle, distal ureter, or renal) were abstracted from imaging reports, while index admissions were determined from hospital discharge abstracts. We used multivariable linear regression to determine the association of arrival pain with stone characteristics and hydronephrosis severity (primary outcome), and we used multivariable logistic regression to determine the association of pain with index hospitalization (secondary outcome). We also performed a stratified analysis looking at ureteral vs. kidney (intrarenal) stones. Results: We studied 1053 patients, 66% male, with a mean age of 48 years. After controlling for patient and disease characteristics, we found no significant association between pain severity and stone size (b=−0.0004; 95%CI = -0.0015, 0.0008) or stone location (b = 0.0045; 95%CI: -0.020, 0.029). Nor did we find an association between pain and hydronephrosis severity (b = 0.016; 95%CI: -0.053, 0.022, p = 0.418). Stratified analyses using a Bonferroni correction for multiple comparisons revealed the same absence of associations in the kidney and ureteral stone subgroups. Arrival pain did not predict index admission (OR = 0.82, 95% CI: 0.59, 1.16). Conclusion: Arrival pain scores are not associated with stone size, stone location or hydronephrosis severity, and do not predict index visit hospitalization in ED patients with renal colic. Severe pain should motivate efforts to minimize treatment delays, but do not suggest the need to modify advanced imaging or admission decisions.

scholarly journals HAEMATURIA AND COLIC CORRELATION AS CLINICAL PREDICTORS IN URETERAL STONES PATIENTS AT UROLOGY OUTPATIENT UNIT SOETOMO HOSPITAL WITHIN JANUARY 2011 - DECEMBER 2015 PERIOD

2017 ◽  
Vol 24 (2) ◽  
Author(s):  
Wisnu Laksmana ◽  
Johan Renaldo ◽  
Tarmono Djojodimedjo
Keyword(s):  
Medical Records ◽  
Renal Colic ◽  
Clinical Symptoms ◽  
Ureteral Stones ◽  
Clinical Predictors ◽  
Design Data ◽  
Outpatient Unit ◽  
Specificity Test ◽  
Sensitivity Specificity ◽  
The Relationship

Objective: Determine the relationship between clinical symptoms of colic pain and haematuria as a predictor of ureteral stones incident at Dr Soetomo Hospital within a period of five years. Material & methods: This study is a descriptive analytic study using the sensitivity-specificity test with retrospective design. Data were collected from patient's medical records with a ureteral stone diagnosis at outpatient unit Dr Soetomo Hospital within 2011-2015. Results: Renal colic or ureter colic without haematuria had 88.32% specificity and 53.07% sensitivity in the incidence of ureteral stones at Urology Outpatient Unit Dr Soetomo Hospital within 2011-2015 period. Haematuria without colic complaint had 29.37% sensitivity and 90.17% specificity in the incidence of ureteral stones. Colic and haematuria compared with colic had 55.76% sensitivity for the incidence of ureteral stones and 70.09% specificity. While colic and haematuria compared with haematuria had a sensitivity of 77.41% for the incidence of ureteral stones and 65.92% specificity. Colic and haematuria compared to other complaints has a 58.77% sensitivity for ureteral stones incidence and 94.66% specificity. Conclusion: Colic and haematuria are clinical predictors that have a better value than the complaints of colic without haematuria and haematuria without colic, in the ureteral stones incident at Urology Outpatient Unit Dr Soetomo Hospital within 2011-2015 period. This is consistent with the literature that mentions prominent complaint in the incidence of ureteral stones is their colic pain caused by the stone through the ureteral passage, and followed by haematuria for their mucosal surface injury.

scholarly journals Findings of Non-enhanced Abdominal Computed Tomography for Pain Management of Acute Renal Colic Patients in the Emergency Department

2020 ◽  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Soft Tissue ◽  
Renal Colic ◽  
Repeated Administration ◽  
Pain Medication ◽  
Ureteral Stones ◽  
Large Size ◽  
Acute Renal Colic ◽  
Enhanced Computed Tomography

Study Objectives: To identify non-enhanced computed tomography (NECT) findings related to repeated requirement of painkiller, hospitalization and revisits within 5 days of discharge among acute renal colic patients. Patients and methods: A retrospective observational study was performed for all patients (age > 18 years) with acute renal colic who visited the emergency department (ED) between 2012 and 2015. NECT findings of acute ureterolithiasis (size, location, hydronephroureter, perinephric infiltrations and soft-tissue rim sign) were analysed for their relationships to repeated administration of painkiller, hospitalization and ED revisit. Results: Of total 862 patients enrolled, 305 (35.4%) required repeated administration of pain medication. In the NECT findings, hydronephroureter was more prevalent in the repeated administration of painkiller group (61.3% vs. 53.7%), but did not show independent relationship. Sixty-eight (7.9%) were hospitalized and 44 (5.1%) returned to the ED. The significant findings associated with hospitalization were hydronephroureter (OR [Odd Ratio] 1.92, 95%CI [Confidence Intervals] 1.04–3.54) and mid (5–7 mm) / large-size (> 7mm) ureteral stones (OR 2.66, 95% CI 1.49–4.76 and OR 4.78, 95% CI 1.80–12.70). The soft-tissue rim signs (OR 2.16, 95%CI 1.07–4.37) and proximal/mid location of stones (OR 3.21, 95% CI 1.26–8.20 and OR 2.53, 95% CI 1.19–5.37) were independently associated with ED revisit. Conclusions: Among the NECT findings of acute ureterolithiasis, hydronephroureter and stones > 5 mm in size were independently associated with the need of hospitalization. The soft-tissue rim sign and proximal/mid location of stones were independently associated with ED revisit within 5 days.

Nonobstructive urinary tract dilatation in children with diabetes insipidus

2012 ◽  
Vol 47 (4) ◽  
pp. 752-755 ◽  
Author(s):  
Daniel Colliver ◽  
Rowland Storey ◽  
Hannah Dickens ◽  
Ramnath Subramaniam
Keyword(s):  
Urinary Tract ◽  
Diabetes Insipidus ◽  
Urinary Tract Dilatation
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