KUMJ | VOL. 14 | NO. 2 | ISSUE 54 | APR-JUN. 2016
Bedside Ultrasound in the Emergency Department to Detect Hydronephrosis for the Evaluation of Suspected Ureteric Colic
Shrestha R, Shakya RM, Khan A
Abstract: Background
Renal colic is a common emergency department presentation. Hydronephrosis is
indirect sign of urinary obstruction which may be due to obstructing ureteric calculus
and can be detected easily by bedside ultrasound with minimal training.
Objective
To compare the accuracy of detection of hydronephrosis performed by the emergency
physician with that of radiologist’s in suspected renal colic cases.
Method
This was a prospective observational study performed over a period of 6 months.
Patients >8 years with provisional diagnosis of renal colic with both the bedside
ultrasound and the formal ultrasound performed were included. Presence of
hydronephrosis in both ultrasounds and size and location of ureteric stone if present in
formal ultrasound was recorded. The accuracy of the emergency physician detection
of hydronephrosis was determined using the scan reported by the radiologists as the
“gold standard” as computed tomography was unavailable. Statistical analysis was
executed using SPSS 17.0.
Result
Among the 111 included patients, 56.7% had ureteric stone detected in formal
ultrasound. The overall sensitivity, specificity, positive predictive value and negative
predictive value of bedside ultrasound performed by emergency physician for
detection of hydronephrosis with that of formal ultrasound performed by radiologist
was 90.8%., 78.3%, 85.5% and 85.7% respectively. Bedside ultrasound and formal
ultrasound both detected hydronephrosis more often in patients with larger stones
and the difference was statistically significant (p=.000).
Conclusion
Bedside ultrasound can be potentially used as an important tool in detecting clinically
significant hydronephrosis in emergency to evaluate suspected ureteric colic.
Focused training in ultrasound could greatly improve the emergency management
of these patients.
Keyword : Bedside ultrasound, hematuria, hydronephrosis, nephrolithiasis, renal colic, ureteric colic
