Juan Jesús Pérez-Núñez 1
Pablo Olea-Rodríguez 1
Rafael Manuel Palacios-López 1
1 Faculty of Medicine, University of Granada (UGR)
Celia Martínez-Coronado 2
África Morillas-Steveaux 2
Sergio Ruiz-Martos 2
Mario Sánchez-Cortés-Macías 3
Miguel Sillero Romero 2
Pablo Torregrosa-Parra 4
Diego García-Vergara 5
2 Faculty of Translation and Interpreting, University of Granada (UGR)
3 Faculty of Philosophy and Letters, University of Liège (ULiège)
4 Faculty of Translation and Interpreting, Autonomous University of Barcelona (UAB)
5 Faculty of Humanities, University Pablo de Olavide (UPO)
Renal colic (RC) caused by lithiasis is a common reason for presentation to the emergency department. Its diagnosis is usually based on the patient’s clinical picture, but it is sometimes necessary to perform complementary imaging tests. Even though the patient is exposed to high radiation doses, computed tomography (CT) of abdomen and pelvis is the gold standard test to confirm RC by lithiasis. That is why it is necessary to implement and analyze the performance of other imaging tests such as abdominal ultrasound (AUS), which is increasingly becoming more important in clinical practice. The objective of this study was to evaluate the role of AUS in diagnosing a suspected acute RC by lithiasis and the use of other imaging tests in clinical practice.
This is a retrospective observational study of a cohort of patients with suspected acute RC who underwent an AUS, as requested by the emergency department of a third-level hospital. Different variables related to the patient’s clinical picture, the performed imaging tests and their findings were analyzed. Moreover, both descriptive and analytical analysis of the main variables of interest were conducted: positive diagnosis, use of low radiation dose protocols, and association between pain intensity and other relevant variables.
In this study, a total of 80 patients were analyzed. Of the 64 patients (80% out of the overall sample) who underwent an abdominal radiography (AR), the radiologist was able to detect lithiasis in 18.8% of patients (34.4%), whereas the emergency physician identified it in 7.8% of them (90.6%). The presence of lithiasis was confirmed by AUS in 43.8% of patients. CT was complementarily conducted, diagnosing lithiasis in 38.8% of patients, of whom 90.3% had not been previously diagnosed with lithiasis. A low radiation dose protocol was applied to 48.3% of the latter, and statistically significant differences were found between the mean radiation dose to which those patients were exposed and the one administered when such protocol was not applied. AUS results were neither significantly associated with the pain intensity of the patient’s clinical picture, nor with a previous diagnosis of lithiasis.
AUS is a non-invasive test that offers significant diagnostic results if acute RC is suspected. Low radiation dose protocols are employed in CT with certain frequency when the presence of acute RC is suspected. However, it is necessary to implement intervention protocols that guarantee the appropriate use of this imaging test in clinical practice.
Keywords: urolithiasis, renal colic, ultrasound, computed tomography, emergency department.