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Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic.

Ahmad NA, Ather MH, Rees J - BMC Urol (2003)

Bottom Line: Overall the incidental findings (additional or alternative diagnosis) were found in 28 (12%) CT scans.Twenty (71%) of these diagnoses were confirmed by per-operative findings, biopsy, and other radiological and biochemical investigations or on clinical follow up.In the present series of 233 consecutive CT examinations, the incidence of incidental diagnosis was 12%.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Urology, Department of Surgery, The Aga Khan University, Karachi. nazim.ahmed@aku.edu

ABSTRACT

Background: Patients presenting in the emergency room with flank pain suggestive of acute ureteric colic may have alternative underlying conditions mimicking ureteric stones. An early diagnosis and appropriate treatment for other causes of flank pain is important. The majority of centers around the world are increasingly using un-enhanced helical CT (UHCT) for evaluation of ureteric colic. This study was conducted to determine the incidence and spectrum of significant incidental diagnoses established or suggested on UHCT performed for suspected renal/ureteric colic.

Methods: Urologist and radiologist reviewed 233 consecutive UHCT, performed for suspected renal/ureteral colic along with assessment of the medical records. Radiological diagnoses of clinical entities not suspected otherwise were analyzed. All other relevant radiological, biochemical and serological investigations and per-operative findings were also noted.

Results: Ureteral calculi were identified in 148 examinations (64%), findings of recent passage of calculi in 10 (4%) and no calculus in 75 examinations (32%). Overall the incidental findings (additional or alternative diagnosis) were found in 28 (12%) CT scans. Twenty (71%) of these diagnoses were confirmed by per-operative findings, biopsy, and other radiological and biochemical investigations or on clinical follow up.

Conclusion: A wide spectrum of significant incidental diagnoses can be identified on UHCT performed for suspected renal/ureteral colic. In the present series of 233 consecutive CT examinations, the incidence of incidental diagnosis was 12%.

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A 40-year old lady presented to the emergency room with a 12-hour history of severe left flank pain radiating downwards and backwards. She was tender in the left flank and hypochondrium. Her urine examination showed microscopic hematuria. An initial diagnosis of left ureteric colic was made. However, UHCT showed an inflamed pancreatic tail (Arrow). A raised amylase and lipase confirmed the diagnosis of acute pancreatitis.
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Figure 2: A 40-year old lady presented to the emergency room with a 12-hour history of severe left flank pain radiating downwards and backwards. She was tender in the left flank and hypochondrium. Her urine examination showed microscopic hematuria. An initial diagnosis of left ureteric colic was made. However, UHCT showed an inflamed pancreatic tail (Arrow). A raised amylase and lipase confirmed the diagnosis of acute pancreatitis.


Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic.

Ahmad NA, Ather MH, Rees J - BMC Urol (2003)

A 40-year old lady presented to the emergency room with a 12-hour history of severe left flank pain radiating downwards and backwards. She was tender in the left flank and hypochondrium. Her urine examination showed microscopic hematuria. An initial diagnosis of left ureteric colic was made. However, UHCT showed an inflamed pancreatic tail (Arrow). A raised amylase and lipase confirmed the diagnosis of acute pancreatitis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC153478&req=5

Figure 2: A 40-year old lady presented to the emergency room with a 12-hour history of severe left flank pain radiating downwards and backwards. She was tender in the left flank and hypochondrium. Her urine examination showed microscopic hematuria. An initial diagnosis of left ureteric colic was made. However, UHCT showed an inflamed pancreatic tail (Arrow). A raised amylase and lipase confirmed the diagnosis of acute pancreatitis.
Bottom Line: Overall the incidental findings (additional or alternative diagnosis) were found in 28 (12%) CT scans.Twenty (71%) of these diagnoses were confirmed by per-operative findings, biopsy, and other radiological and biochemical investigations or on clinical follow up.In the present series of 233 consecutive CT examinations, the incidence of incidental diagnosis was 12%.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Urology, Department of Surgery, The Aga Khan University, Karachi. nazim.ahmed@aku.edu

ABSTRACT

Background: Patients presenting in the emergency room with flank pain suggestive of acute ureteric colic may have alternative underlying conditions mimicking ureteric stones. An early diagnosis and appropriate treatment for other causes of flank pain is important. The majority of centers around the world are increasingly using un-enhanced helical CT (UHCT) for evaluation of ureteric colic. This study was conducted to determine the incidence and spectrum of significant incidental diagnoses established or suggested on UHCT performed for suspected renal/ureteric colic.

Methods: Urologist and radiologist reviewed 233 consecutive UHCT, performed for suspected renal/ureteral colic along with assessment of the medical records. Radiological diagnoses of clinical entities not suspected otherwise were analyzed. All other relevant radiological, biochemical and serological investigations and per-operative findings were also noted.

Results: Ureteral calculi were identified in 148 examinations (64%), findings of recent passage of calculi in 10 (4%) and no calculus in 75 examinations (32%). Overall the incidental findings (additional or alternative diagnosis) were found in 28 (12%) CT scans. Twenty (71%) of these diagnoses were confirmed by per-operative findings, biopsy, and other radiological and biochemical investigations or on clinical follow up.

Conclusion: A wide spectrum of significant incidental diagnoses can be identified on UHCT performed for suspected renal/ureteral colic. In the present series of 233 consecutive CT examinations, the incidence of incidental diagnosis was 12%.

Show MeSH
Related in: MedlinePlus