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.

scholarly journals Implications of Changing from Intravenous Urography to Computed Tomography as the Primary Imaging Modality for Acute Renal Colic

2013 ◽  
Vol 95 (2) ◽  
pp. 1-4
Author(s):  
SP McCombie ◽  
BW Turney ◽  
AM Rogers ◽  
IJ Lau ◽  
SPV Kumar
Keyword(s):  
Computed Tomography ◽  
Renal Impairment ◽  
Renal Colic ◽  
Imaging Modality ◽  
Intravenous Urography ◽  
Contrast Reaction ◽  
Acute Renal Colic ◽  
Unenhanced Computed Tomography ◽  
Higher Sensitivity

Several studies have shown that unenhanced computed tomography (CT), while having a similar specificity to intravenous urography (IVU) for detecting ureterolithiasis, has a much higher sensitivity. CT is also more effective in identifying alternative pathologies and is known to be a much quicker investigation to perform. Additionally, CT can be used in patients with renal impairment and carries no risk of contrast reaction.

scholarly journals Risk of acute kidney injury after contrast-enhanced computed tomography in emergency department

2020 ◽  
pp. 102490792091339
Author(s):  
Seda Dağar ◽  
Emine Emektar ◽  
Hüseyin Uzunosmanoğlu ◽  
Şeref Kerem Çorbacıoğlu ◽  
Özge Öztekin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Contrast Media ◽  
Kidney Injury ◽  
Intravenous Contrast ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Despite its risks associated with renal injury, intravenous contrast media increases diagnostic efficacy and hence the chance of early diagnosis and treatment, which leaves clinicians in a dilemma regarding its use in emergency settings. Objective: The aim of this study was to determine the risk and predictors of contrast-induced acute kidney injury following intravenous contrast media administration for computed tomography in the emergency department. Methods: All patients aged 18 years and older who had a basal creatinine measurement within the last 8 h before contrast-enhanced computed tomography and a second creatinine measurement within 48–72 h after computed tomography scan between 1 January 2015 and 31 December 2017 were included in the study. Characteristics of patients with and without contrast-induced acute kidney injury development were compared. Multivariate regression analysis was used to assess the predictors for contrast-induced acute kidney injury. Results: A total of 631 patients were included in the final statistical analysis. After contrast media administration, contrast-induced acute kidney injury developed in 4.9% ( n = 31) of the patients. When the characteristics of patients are compared according to the development of contrast-induced acute kidney injury, significant differences were detected for age, initial creatinine, initial estimated glomerular filtration rate, and all acute illness severity indicators (hypotension, anemia, hypoalbuminemia, and need for intensive care unit admission). A multivariate logistic regression analysis was performed. The need for intensive care unit admission (odds ratio: 6.413 (95% confidence interval: 1.709–24.074)) and hypotension (odds ratio: 5.575 (95% confidence interval: 1.624–19.133)) were the main factors for contrast-induced acute kidney injury development. Conclusion: Our study results revealed that hypotension, need for intensive care, and advanced age were associated with acute kidney injury in patients receiving contrast media. Therefore, we believe that to perform contrast-enhanced computed tomography in emergency department should not be decided only by checking for renal function tests and that these predictors should be taken into consideration.

Ureteric stones

2017 ◽  
Author(s):  
Samarpit Rai ◽  
Zachariah G. Goldsmith ◽  
Michael E. Lipkin ◽  
Glenn M. Preminger
Keyword(s):  
Renal Colic ◽  
The United States ◽  
Primary Diagnosis ◽  
Ureteral Stones ◽  
Emergency Room Visits ◽  
Narcotic Analgesics ◽  
Acute Renal Colic ◽  
Pharmacologic Management ◽  
Year 2000 ◽  
Targeted Approach

Acute renal colic is a common presentation to the emergency department. It is estimated that about 12% of men and 5% of women will have at least one symptomatic stone by the age of 70. Renal colic has an annual incidence 16 cases per 10,000 per year, and a lifetime incidence of 2–5%. In the year 2000, there were over 600,000 emergency room visits for urolithiasis listed as the primary diagnosis in the United States alone. In this chapter, acute pharmacologic management of patients diagnosed with ureteral stones will be outlined. The pharmacology and clinical efficacy for narcotic and non-narcotic analgesics will be reviewed. In addition, medical expulsive therapy using alpha blockers and other agents will be extensively reviewed, in order to provide a targeted approach to the pharmacologic management of patients diagnosed with acute renal colic secondary to a ureteral stone.

Retrospective Review of Acute Renal Colic Management in the Emergency Department and Review of Guidelines

2018 ◽  
Vol 5 (2) ◽  
pp. 113-119 ◽  
Author(s):  
J. Jackson ◽  
J. Farhi ◽  
K. Wheeler ◽  
G. Rueb ◽  
C. Thom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Retrospective Review ◽  
Renal Colic ◽  
Acute Renal Colic
Sign in / Sign up

Export Citation Format

Share Document