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Ralph C Wang, Newton Addo, Thomas Chi, Christopher Moore, Michael Mallin, Stephen Shiboski, Marshall Stoller, Rebecca Smith-Bindman
OBJECTIVE: Recent studies have clarified the role of alpha-blockers, such as tamsulosin, for patients diagnosed with ureteral stones <10mm not requiring an urgent intervention. Prior studies have reported low rates of use of MET by emergency physicians. We sought to describe patterns of alpha-blocker use and to determine factors associated with utilization in patients diagnosed with ureterolithiasis in the ED. METHODS: We used data from a randomized trial of CT scan vs...
February 28, 2017: American Journal of Emergency Medicine
Graham Zoller, Isabelle Langlois, Kate Alexander
CASE DESCRIPTION A 3-year-old and a 7-year-old spayed female rabbit (Oryctolagus cuniculus) were evaluated because of digestive stasis associated with renal asymmetry. CLINICAL FINDINGS Neoplasia of the right kidney was diagnosed via cytologic analysis in the 3-year-old rabbit. Ureterolithiasis of the left kidney was diagnosed via abdominal ultrasonography in the 7-year-old rabbit. To evaluate whether unilateral nephrectomy was indicated, evaluation of glomerular filtration rate by dynamic CT (CT-GFR) was performed on both rabbits...
March 15, 2017: Journal of the American Veterinary Medical Association
M I Kogan, I I Belousov, Akef Maarouf Yassine Akef Maarouf Yassine
Expert panels of AUA and EAU defined highly effective approaches to surgical treatment of ureterolithiasis and recommended extracorporeal and contact lithotripsy as the main options. Therapeutic strategy for ureteral stones measuring less than 10 mm is clearly defined and supported by the Russian Society of Urology. At the same time, the views of researchers on the management of large ureteral stones vary. This literature review provides information on the results of extracorporeal shock-wave lithotripsy and contact ureterolithotripsy of large stones located in various parts of the ureter...
December 2016: Urologii︠a︡
Lena Naffaa, Tejaswini Deshmukh, Shanthan Tumu, Chris Johnson, Kevin P Boyd, Arthur B Meyers
Identifying the etiology of acute pelvic pain in girls is often clinically challenging. Particularly in young girls, it is often difficult to determine if acute pelvic symptoms are originating from a gynecologic source or from a genitourinary or gastrointestinal etiology based on the child's clinical examination alone. Therefore, imaging plays a key role in establishing a diagnosis and in directing medical and surgical treatment. Pediatric gynecologic conditions, which can present acutely with pain or mass or both include ovarian torsion, hematometrocolpos, pelvic inflammatory disease, inguinal hernias containing an ovary or the uterus or both, adnexal cysts, pregnancy, vaginal foreign bodies, and ovarian vein thrombosis...
December 21, 2016: Current Problems in Diagnostic Radiology
Keith Pace, Karl Spiteri, Karl German
We present the case of a 37-year-old lady who presented with severe colicky left sided flank pain associated with vomiting, chills and rigors. A non-contrast Computed Tomography of the Kidney Ureter and Bladder was performed which showed a 2-3 mm stone in the pelvic part of the left ureter. Following 2 days of conservative treatment she was still complaining of increasingly severe pain. A contrast computed tomography of the abdomen was performed which was suggestive of a perforation of the left collecting system...
January 9, 2017: Journal of Surgical Case Reports
E Lavdas, N Boci, L Sarantaenna, A Godevenos, I Ntavelis, T Theodoropoulos, G Zaimis, P Mavroidis
PURPOSE: The purpose of this study is to report the case of a young adult in which the incomplete oral administration of contrast material led to diagnosis of an appendicolith, which cause acute appendicitis. METHODS: A male 34 years old underwent CT examination due to acute abdominal pain in the upper abdomen. An ultrasound examination of the upper abdomen and kidneys, an x-ray examination of the abdomen and a CT scan of the entire abdomen and pelvis after both oral and IV administration of contrast material were performed...
June 2016: Medical Physics
Elizabeth M Schoenfeld, Penelope S Pekow, Meng-Shiou Shieh, Charles D Scales, Tara Lagu, Peter K Lindenauer
OBJECTIVES: Symptomatic ureterolithiasis (renal colic) is a common Emergency Department (ED) complaint. Variation in practice surrounding the diagnosis and management of suspected renal colic could have substantial implications for both quality and cost of care as well as patient radiation burden. Previous literature has suggested that CT scanning has increased with no improvements in outcome, owing at least partially to the spontaneous passage of kidney stones in the majority of patients...
2017: PloS One
Matthias Meissnitzer, Thomas Meissnitzer, Stephan Hruby, Stefan Hecht, Andreas Gutzeit, Laura Holzer-Frühwald, Klaus Hergan, Rosemarie Forstner
PURPOSE: To retrospectively evaluate whether prone CT scanning is superior to supine scanning for correct localization of distal urinary calculi in patients with acute flank pain. METHODS: Consecutively performed unenhanced CT scans in patients with acute flank pain were retrospectively analyzed in 150 patients in supine and another 150 patients in prone position. Images were reviewed by two radiologists on consensus. Findings in both groups were compared using two-sided Fisher Exact tests and Wilcoxon-Mann-Whitney test...
February 2017: Abdominal Radiology
Toru Kameda, Nobuyuki Taniguchi
Point-of-care abdominal ultrasound (US), which is performed by clinicians at bedside, is increasingly being used to evaluate clinical manifestations, to facilitate accurate diagnoses, and to assist procedures in emergency and critical care. Methods for the assessment of acute abdominal pain with point-of-care US must be developed according to accumulated evidence in each abdominal region. To detect hemoperitoneum, the methodology of a focused assessment with sonography for a trauma examination may also be an option in non-trauma patients...
2016: Journal of Intensive Care
Dimitri Papagiannopoulos, Patrick Whelan, Waseem Ahmad, James Rybak, Bala Hota, Leslie Deane, Ajay Nehra
PURPOSE: The appropriate management of infected obstructing ureteral calculi is prompt genitourinary decompression. Urine cultures are the gold standard for confirming infection but often take 24-48 h to result. Although white blood cell (WBC) count is an important diagnostic laboratory test, it is a nonspecific inflammatory marker. Similarly, urinalysis (UA) can be misleading in the setting of a contaminated sample, bladder colonization, or in cases of a completely obstructed the upper urinary tract...
July 2016: Urology Annals
Koichi Kodama, Yasukazu Takase, Hiroki Tatsu
Crossed renal ectopia is a rare congenital anomaly in which both kidneys are situated on one side and fused together in 85%-90% of cases. The management of urinary calculi in patients with crossed renal ectopia continues to pose challenges to urologists because the aberrant anatomy may make access and clearance of the calculi more difficult to accomplish. Here, we report a case of inferior crossed renal ectopia, without fusion, and a ureteral stone in which the patient was treated successfully by extracorporeal shock wave lithotripsy...
2016: Case Reports in Urology
Bardia Moosavi, Najla Fasih, Vivek Virmani, Ania Kielar
Nephrolithiasis is the most common condition involving the ureters. However, various other entities can affect the ureters, albeit less frequently. Imaging plays a crucial role in diagnosis, management, and follow-up of ureteral pathology. In the past decade, computed tomography urography has replaced traditional methods of ureteral imaging due to its high spatial resolution, multiplanar imaging, and rapid acquisition time. More recently, magnetic resonance urography has also been explored in evaluating ureteral abnormalities...
July 2016: Clinical Imaging
Hiroki Fukuhara, Osamu Ichiyanagi, Hiroshi Kakizaki, Sei Naito, Norihiko Tsuchiya
Ureterolithiasis is one of the most frequently diagnosed urologic diseases worldwide. Its annual incidence in Japan increased three-fold from 1965 to 2005. Ureterolithiasis incidence is affected by numerous factors, including race, sex, body weight, fluid intake, and climate. Here, we aimed to address the latter by considering the effect of seasonal variation on stone incidence and incorporating this information into a predictive model for differential diagnosis of ureteral stone from other conditions with similar presentations...
November 2016: Urolithiasis
Toru Kameda, Fukiko Kawai, Nobuyuki Taniguchi, Ikuo Mori, Masako Ono, Noriko Tsukahara, Yasuyuki Kobori, Hidetoshi Yoshida, Kazuko Wagai, Atsuko Numao
PURPOSE: To evaluate the relationship between the degree of hydronephrosis and the detection rates of ureteral stones with ultrasonography (US). METHODS: Of 250 consecutive patients with suspected ureterolithiasis, 214 who were diagnosed with ureterolithiasis were enrolled in this study. First, both kidneys were observed by US to evaluate the intrarenal collecting systems. Thereafter, the possible course of the ureters and the bladder were searched to find any stones...
January 2010: Journal of Medical Ultrasonics
Volkan Sen, Cetin Imamoglu, Ibrahim Kucukturkmen, Tansu Degirmenci, Ibrahim Halil Bozkurt, Tarik Yonguc, Ozgu Aydogdu, Bulent Gunlusoy
We aimed to evaluate the use of twinkling artifact (TA) on color Doppler ultrasonography (USG) as an alternative imaging modality to non-contrast-enhanced computed tomography (CT) in patients with ureteral stones in this prospective study. Totally, 106 consecutive patients who had been diagnosed with ureterolithiasis by CT were enrolled in this prospective study. A urinary system color Doppler ultrasonography was performed on the same day with CT by an experienced radiologist who was blinded to the CT scan...
April 2017: Urolithiasis
Kevan M Sternberg, Vernon M Pais, Troy Larson, Jullet Han, Natalia Hernandez, Brian Eisner
PURPOSE: Renal ultrasound accurately identifies hydronephrosis but it is less sensitive than computerized tomography for the detection of ureterolithiasis. We investigated whether the presence of hydronephrosis on ultrasound was associated with a ureteral stone in patients who underwent both ultrasound and computerized tomography during the evaluation of acute renal colic. MATERIALS AND METHODS: We retrospectively reviewed the records of patients from 3 institutions who were evaluated for acute renal colic by both ultrasound and computerized tomography between 2012 and 2015...
October 2016: Journal of Urology
Dean Markić, Kristian Krpina, Juraj Ahel, Antun Gršković, Josip Španjol, Nino Rubinić, Mauro Materljan, Ivana Mikolašević, Lidija Orlić, Sanjin Rački
We report a case of a kidney-transplanted patient with urolithiasis treated with mini-percutaneous laser lithotripsy. The patient presented with renal dysfunction and graft hydronephrosis. Diagnostic procedures revealed ureterolithiasis as a cause of obstruction, and percutaneous nephrostomy was inserted as a temporary solution. Before surgery, the stone migrated to the renal pelvis. Mini-percutaneous laser lithotripsy was successfully performed, and during surgery, all stone fragments were removed. Six months after successful treatment, the patient has good functioning and stone-free graft...
January 2016: Case Reports in Nephrology and Dialysis
Romy M Heilmann, Medora Pashmakova, Jodie H Lamb, Kathy A Spaulding, Audrey K Cook
A 6-year-old female spayed Domestic Shorthair cat was presented with acute lethargy, dehydration, marked azotemia, metabolic acidosis, left-sided renomegaly, and bilateral hydronephrosis. Ureterolithiasis and ureteral obstruction were suspected based on further diagnostics including abdominal sonography. Medical treatment was not successful. Fluoroscopically guided antegrade pyelography confirmed the diagnosis of bilateral ureteral obstruction due to ureterolithiasis. Subcutaneous ureteral bypass (SUB) devices were placed bilaterally, followed by close patient monitoring...
June 16, 2016: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
F P Glina, P M V Castro, G G R Monteiro, G C Del Guerra, Sidney Glina, M Mazzurana, W M Bernardo
INTRODUCTION: Urinary lithiasis is the main urologic cause of emergency treatment in adult patient. In the past years, the incidence in children population has increased. However, literature about the use of alpha-1 adrenergic blockers in pediatric population with distal ureterolithiasis is still scarce. The drug acts by decreasing ureter contractions, especially in the distal portion, facilitating calculus expulsion. OBJECTIVE: This review has the objective to evaluate the use of alpha-1 adrenergic blockers as medical expulsive treatment in children with distal ureterolithiasis...
November 2015: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Yan Song, Natalia Hernandez, Michael S Gee, Vicki E Noble, Brian H Eisner
INTRODUCTION: While computerized tomography (CT) is the gold standard for diagnosis of ureterolithiasis, ultrasound is a less costly and radiation-free alternative which is commonly used to evaluate patients with ureteral colic. The purpose of this study was to evaluate the frequency with which patients with ureteral stones and renal colic demonstrate hydronephrosis in order to better understand the evaluation of these patients. METHODS: Two hundred and forty-eight consecutive patients presenting with ureteral colic and diagnosed with a single unilateral ureteral stone on CT scan in an urban tertiary care emergency department were retrospectively reviewed...
September 2016: World Journal of Urology
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