Factors affecting the undetectable ureteric stone in the abdominal ultrasound of patients with acute abdominal pain in the emergency room at Nan Hospital
Keywords:
Ureteric stone, Abdominal ultrasound, HydronephrosisAbstract
Introduction: The diagnosis of patients with obstructive ureteric stone in emergency room by abdominal ultrasound (Abdominal US) is important and provides quick diagnosis, but the accuracy of the examination may be differences.
Objectives: To study characteristics of patients with obstructive ureteric stone in the emergency room at Nan Hospital, comparing patients diagnosed through abdominal US and diagnosed through non-contrast abdominal CT, and identify factors leading to non-detection of ureteric stone in abdominal US.
Methods: A retrospective study was performed from 1st January 2021 to 31st December 2022, in patients aged 18 and older who visited the emergency room at Nan Hospital due to acute abdominal pain and underwent preliminary abdominal US examination by emergency physicians or other healthcare professionals on duty in the emergency room at that time. Subsequently, they were referred to radiologist for re-evaluated abdominal US examination. The definite diagnosis of all obstructive ureteric stones were confirmed by radiologists or urologists in cases of operation. Descriptive statistics and logistic regressions were used to analyze the data.
Results: From 392 cases, divided into two groups, there were 224 cases of group in which no ureteric stone found in the abdominal US examination but diagnosed from the non-contrast abdominal CT (Detectable UC by CT) and 168 cases of group in which ureteric stone detected from abdominal US examination (Detectable UC by US). Most of patients were male, about 73.7% and 66.1%, aged 55.71±12.40 years and 54.58±12.24 years, p=1.000 and BMI 23.78±4.18 kg/m2 and 23.31±3.33 kg/m2, p=0.448, respectively. The factors affect non-detection of ureteric stone in the abdominal US examination including mild hydronephrosis, Adj.OR 2.97 (95% CI 1.06-3.99) p=0.033, mid ureteric location, Adj.OR 2.97 (95%CI 1.18-7.51) p=0.021 and stone size not exceeding 0.5 centimeters, Adj.OR 10.69 (95%CI 4.69-24.40) P <0.001
Conclusion: From this study, the non-detection of ureteric stone using Abdominal US in emergency room is associated with the degree of hydronephrosis, mid ureteric location and stone size not exceeding 0.5 centimeters. Therefore, in patients suspected of having obstructive ureteric stone, additional examination with non-contrast abdominal CT is important.
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