Purpose
OBJECTIVE:
To demonstrate the use of non-contrast CT KUB (stone protocol) in the detection of abdominal pathologies other than stones, whether or not simulating the clinical picture of urolithiasis, and its impact upon patient management.
BACKGROUND & INTRODUCTION:
CT KUB has a higher sensitivity for detecting urolithiasis as compared toX ray KUB. One of the major advantages of CT KUB over plain radiography is its ability to diagnose incidental findings or alternative causes of abdominal pain that can affect health 1. As multidetector CT has...
Methods and materials
STUDY DESIGN:
This was a cross sectional analytical study carried out in Radiology department of Rehman Medical Institute Peshawar from Dec 2012 to May 2018.
SUBJECTS:
2776 patients coming for CT KUB in the duration were included. All patients who were referred from the emergency department, from hospital clinics and those who were inpatients were included in the study.The patients with previous surgery for renal or ureretic stones were excluded. Age range was 10 to 90 years and patients presented with persistent or recurrent pain...
Results
The encountered acute abdominal non-renal pathologies were overall seen in 236 patients (8.5%). These were pancreatitis in 15, appendix related pathologies in 46, cholelithiasis in 108, cholecystitis in 1, epiploic appendagitis in 8 and hernia in 58 patients. Other non-KUB findings included psoas abscess (2), bowel perforation (2), Liver masses (1), Bone metastasis(2), Dermoid ovarian cysts (2, one of which had torsion), cervical stenosis with fluid distended uterine cavity (1), Prostate mass (2), uterine fibroids, adrenal adenomas(2) and degenerative bone changes, few with osteoporotic collapse....
Conclusion
The results of our study suggest that 8.5% patients were diagnosed with non-renal acute pathologies on non-contrast CT scan, which required immediate intervention.
Non-contrast CT scan of the urinary tract (stone protocol) is a valuable tool in the detection of incidental findings which may simulate, or coincide with urolithiasis and it has a significant impact upon the management of the patients.
Personal information and conflict of interest
Primary author:
Dr. Ummara Siddique Umer
MBBS (KEMC), FCPS (Radiology) , EDiR (EBR)
Consultant Radiologist & Assistant Professor of Radiology
Rehman Medical Institute Peshawar
Pakistan
Disclosure:
U. S. Umer; Peshawar/PK - nothing to disclose
S. Alam; Peshawar/PK - nothing to disclose
A. N. Khan; Peshawar/PK - nothing to disclose
S. G. Ghaus; Peshawar/PK - nothing to disclose
M. Abdullah; Peshawar/PK - nothing to disclose
A. Nawaz; Peshawar/PK - nothing to disclose
M. Asif; Peshawar/PK - nothing to disclose
N. Gul; Peshawar/PK - nothing to disclose...
References
Ahmad N.A., Ather M.H., Rees J. Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic. BMC Urol. 2003;3:2.
Khan N, Ather MH, Ahmed F, Zafar AM, Khan A. Has the significance of incidental findings on unenhanced computed tomography for urolithiasis been overestimated? A retrospective review of over 800 patients. Arab J Urol. 2012;10(2):149–154.
Kirpalani A, Khalili K, Lee S, Haider MA. Renal colic: comparison of use and outcomes of unenhanced helical CT for emergency investigation in 1998 and 2002. Radiology. 2005;236:554-8....