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Ultrasonography in the diagnosis of abdominal pain in emergency department patients

Zbigniew Wolski, Janusz Tyloch, Krzysztof Kwela

Med Sci Monit 1999; 5(5): MT977-981 :: ID: 503439

Abstract

We performed abdominal organ ultrasonography in every patient presenting with lumbar or/and abdominal pain. Due to the presence of upper urinary tract distension or/and deposits, the cause of renal colic can be established. X-ray films of the abdominal cavity have been performed despite the absence of characteristic deposits seen during the ultrasound examination. During the mentioned period, emergency urography had not been performed in patients presenting with renal colic symptoms. The aim of this study was to assess renal colic diagnosis based on the preliminary clinical examination ultrasound examination findings performed in each patient seen at the emergency department.Between April, 1993 and 1996, we examined and treated 1831 patients with renal colic symptoms. In 1427 (77.95%) patients, pain was caused by urolithiasis confirmed by a clinical examination, ultrasound and X-rays. Four (0.2%) patients presented with a bleeding neoplasm of the kidney. In 400 (21.85%) patients the final diagnosis differed from the presumptive diagnosis, i. e. 309 (16.8%) patients were diagnosed with primary pyelonephritis; 78 (4.3%) patients with low-back pain, 7 (0.4%) patients with a perinephric abscess, 5 (0.3%) patients with colic during the course of cholecystolithiasis and one patient with a dissecting aneurysm of the abdominal aorta. 176 (9.6 %) patients, required an immediate nephrostomy due to marked distension of the upper urinary tract confirmed by ultrasound, or/and acute infection symptoms.In the majority of patients, ultrasound and X-ray examinations established the cause of acute lumbar pain, thus eliminating the need for urography. An urologist performing the ultrasound examination should examine not only the urinary tract, but all abdominal organs as well.

Keywords: emergency department, renal colic, ultrasound

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750