| The role of emergency ultrasound for evaluating acute pyelonephritis in the ED. | |
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MedLine Citation:
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PMID: 20825875 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Controversy remains over the imaging method of choice for evaluating acute pyelonephritis (APN) in the emergency department (ED). OBJECTIVE: The aim of the study was to determine the efficacy of ultrasound in the diagnosis and management of patients presented to the ED with APN. METHODS: This was a retrospective study of prospectively collected data. A cohort of ED patients diagnosed as APN were prospectively registered, and their medical records were then retrospectively reviewed for the presence of complications (admitted >14 days, admission to intensive care unit, or received invasive procedures), significant abnormalities (hydronephrosis, polycystic kidney diseases, renal abscess, emphysematous pyelonephritis), and mild abnormalities (cysts, stones, swelling). RESULTS: The study included 243 patients. Most of the patients received one or more renal imaging studies (n = 206) and 39.5% of which were considered abnormal. The rates of significant abnormalities on different imaging methods were Kidney-ureter-bladder (KUB), 16.3%; emergency ultrasound (EUS), 39.6%; combination of KUB and EUS, 56.6%; and computed tomography, 58.8%. Factors contributed to complicated APN were elderly, male, a history of preexisting renal diseases, current use of catheters, previous renal calculi, and diabetes mellitus. Significant abnormalities can be identified by EUS in 61% of patients with complicated APN. In fact, the presence of significant sonographic abnormalities effectively diverted 34.3% of patients to receive surgical interventions (percutaneous nephrostomy, abscess aspiration, ureteroscopic stone manipulation, lithotripsy, or nephrectomy). CONCLUSION: Structural abnormalities are not uncommon in ED patients with APN. Early assessment of these patients with EUS is likely to have a great impact on their diagnosis and management. |
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Authors:
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Kuo-Chih Chen; Shih-Wen Hung; Vei-Ken Seow; Chee-Fah Chong; Tzong-Luen Wang; Yu-Chuan Li; Hang Chang |
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Publication Detail:
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Type: Journal Article Date: 2010-05-01 |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 29 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-08-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 721-4 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Emergency Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan, ROC. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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