OPTIMAL USE OF COMPUTED TOMOGRAPHY KIDNEY, URETER, AND BLADDER: REVIEW OF PATIENTS PRESENTING WITH ACUTE FLANK PAIN
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Abstract
Objective: To describe detection and management of alternative pathology established by Computed Tomography (CT) Kidney, Ureter, and Bladder (KUB) in patients associated with acute flank pain.
Method: This retrospective review of 300 patients, presented with acute flank pain during one year from March 2019 to March 2020. All Computerized Tomographies were ordered from the Emergency Room after consultation with a urologist and subsequently reported by a consultant radiologist having a minimum of two years of experience in reporting non-contrast CT scans.
Results: A total of 300 patients presented to the emergency room with acute flank pain, out of whom 198 (66%) were male and 102 (34%) were female patients with a mean age of 35 years. The majority (n=249) of the patients were diagnosed with ureteric calculi and the remaining 51 patients (17%) came out to have alternative radiological findings. Eighteen (35.2%) patients were those who needed acute surgical management which included 13 female and 5 male patients. The remaining 33 (64.7%) patients were referred to specialized clinics as there was no emergency involved. The clinically important alternative findings were overall higher in the female cohort i.e., 25.5% versus 9.8% in male patients. Genitourinary findings were discovered in 11(21.5%) patients while 7 (13.7%) patients had non-genitourinary pathologies requiring emergency management.
Conclusion: CT-KUB is a useful tool for investigating acute flank pain aiding the decision-making process. The majority of the patients were diagnosed to have ureteric calculi with a significant number of alternative diagnoses mainly in the female population.
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