Document Detail


Unenhanced ultrafast computerized tomography for the evaluation of patients with acute flank pain.
MedLine Citation:
PMID:  12081128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the value of unenhanced ultrafast computerized tomography (CT) in the diagnosis of acute flank pain in 43 patients evaluated for suspected stone disease. MATERIAL AND METHOD: Noncontrasted ultrafast CT was performed in 43 consecutive patients seen in the emergency department to evaluate acute flank pain. All CT studies were reviewed for the presence of ureteral and renal calculi, perinephric and periureteral stranding, presence and degree of pelvicalicectasis or other radiological findings. If necessary, an excretory urogram was performed to confirm the presence or absence of urinary stone. Patients were followed to determine clinical outcome including the need for urological intervention. RESULTS: Of the 28 patients determined to have stones 16 (57.14%) had spontaneous stone passage, 7 (25%) had improved symptoms without documented stone passage and 4 (14.29%) required surgical intervention. In 6 of 14 patients (42.86%) with negative CT readings for stone disease a diagnosis was established by other intra-abdominal findings. In 7 patients (50%) no clinical diagnosis could be established, and 1 scan in a patient with a ureteral calculus was interpreted as falsely negative. These findings yielded a sensitivity of 96.63 per cent, Specificity 92.85 per cent and overall accuracy 95.24 per cent for diagnosing ureteral stones. CONCLUSIONS: Unenhanced ultrafast CT is an accurate, safe and rapid imaging modality for the detection of urinary tract calculi and obstruction. The majority of patients required no further imaging to determine the need for urological intervention. Ultrafast CT could be used as the standard method to evaluate patients with acute flank pain.
Authors:
Nithi Pummangura; Wachira Kochakarn; Vira Viseshsindh; Kulkanya Pipatkulsawat; Bussanee Wibulpolprasert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  85     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-06-25     Completed Date:  2002-07-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  256-62     Citation Subset:  IM    
Affiliation:
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Female
Flank Pain / etiology*,  radiography
Humans
Male
Middle Aged
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Urinary Calculi / complications,  radiography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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