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Avoiding Computed Tomography Scans By Using Point-Of-Care Ultrasound When Evaluating Suspected Pediatric Renal Colic.
Ng, Carrie; Tsung, James W.
Afiliación
  • Ng C; Department of Pediatrics, NewYork-Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York.
  • Tsung JW; Departments of Emergency Medicine and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
J Emerg Med ; 49(2): 165-71, 2015 Aug.
Article en En | MEDLINE | ID: mdl-25934378
BACKGROUND: Although renal colic in children in the United States remains relatively uncommon compared to in adults, its incidence has nearly doubled from 1999 to 2008. Noncontrast computed tomography (CT) is the current standard for the evaluation of suspected renal colic, given its high sensitivity and specificity. However, the greater lifetime risk of radiation-induced cancer from CT in pediatric patients has led to efforts to minimize radiation exposure. Additionally, pediatric renal colic is often recurrent, which might require multiple imaging studies during their lifetime. Point-of-care ultrasound (POCUS) by emergency physicians avoids radiation, has a low marginal cost, can be performed concurrently with other management, and allows for earlier diagnosis and more rapid treatment of renal colic. Adult randomized controlled trial evidence supports using POCUS as the initial approach to imaging and management of suspected renal colic. However, there remain limited data on POCUS in children for renal colic. CASE REPORT: This is a case series where the sonographic findings of hydronephrosis, ureteral jets, "twinkling artifact," and the identification of urinary tract stones were used to evaluate adolescent and pediatric patients with renal colic. We report five cases of renal colic in adolescent and pediatric patients where urolithiasis was confirmed by using POCUS and irradiation by CT was avoided in all 5 patients. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: POCUS can provide information about the presence or absence of urinary tract stones as well as obstruction of the collecting system without the cost and radiation exposure of CT.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Sistemas de Atención de Punto / Urolitiasis / Cólico Renal Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Adolescent / Adult / Child, preschool / Female / Humans / Male Idioma: En Revista: J Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2015 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Sistemas de Atención de Punto / Urolitiasis / Cólico Renal Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Adolescent / Adult / Child, preschool / Female / Humans / Male Idioma: En Revista: J Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2015 Tipo del documento: Article