Arslan Ebubekir, Mohamed Abdikarim H
Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia.
Afr J Emerg Med. 2022 Dec;12(4):358-361. doi: 10.1016/j.afjem.2022.07.011. Epub 2022 Aug 14.
Renal colic is a common emergency centre (EC) complaint worldwide, but its epidemiology and strategies for evaluation and treatment have been little reported in Africa. To the best of our knowledge, this is the first study aimed at evaluating the radiological investigations, management, and analysis of demographic characteristics of patients with urinary system stones who visited the EC.
A 3-year retrospective study of a total of 435 patients with acute renal colic who underwent radiologic investigations was included in this study. The overall positive stone rate, stone location, size, and hydronephrosis grade were assessed. The sensitivity and specificity of ultrasound were evaluated using patients with both an ultrasound and a non-contrast CT (NCCT).
The mean age of the patients was 34.7years; males accounted for 71.3% ( = 310), while females were 28.7% ( 125). Urolithiasis was found in 63.4% of the cases, 71.3% of males and 28.7% of the females had a stone diagnosis ( < 0001). There was no statistically significant association between age and stone diagnosis ( > 0.05). The sensitivity and specificity of USG were 86.1% and 94%, respectively. Seventy-two percent of the cases had ureteral stones (29% in proximal, 25% in UVJ, 9% in mid, and 9% in distal ureter), followed by 28% having renal stones (19% calyces and 9% in renal pelvis). The mean size of the stone was 5.9±1.8, half of the cases harbour stone size <5mm, followed by 30% in 5mm-1cm.
Due to the scarcity of well-equipped tertiary care hospitals and the low socioeconomic status of the patients living in Sub-Saharan Africa, Ultrasound can be the initial investigation of choice because it is safe, cheap, and may help guide diagnosis and the need for further imaging. However, NCCT remains the gold standard diagnosis of choice for acute flank pain.
肾绞痛是全球急诊中心常见的病症,但非洲地区对其流行病学以及评估和治疗策略的报道较少。据我们所知,这是第一项旨在评估前往急诊中心就诊的泌尿系统结石患者的影像学检查、管理及人口统计学特征分析的研究。
本研究纳入了一项对435例接受放射学检查的急性肾绞痛患者进行的为期3年的回顾性研究。评估总体结石阳性率、结石位置、大小及肾盂积水分级。利用同时接受超声和非增强CT(NCCT)检查的患者评估超声的敏感性和特异性。
患者的平均年龄为34.7岁;男性占71.3%(n = 310),女性占28.7%(n = 125)。63.4%的病例发现有尿石症,71.3%的男性和28.7%的女性被诊断为结石(P < 0.001)。年龄与结石诊断之间无统计学显著关联(P > 0.05)。超声的敏感性和特异性分别为86.1%和94%。72%的病例有输尿管结石(近端29%,输尿管膀胱连接部25%,中段9%,远端输尿管9%),其次是28%有肾结石(肾盏19%,肾盂9%)。结石的平均大小为5.9±1.8,半数病例结石大小<5mm,其次是5mm - 1cm的占30%。
由于撒哈拉以南非洲地区设备完善的三级护理医院稀缺,且当地患者社会经济地位较低,超声因其安全、廉价且有助于指导诊断及进一步影像学检查需求,可作为首选的初步检查方法。然而,NCCT仍然是急性腰痛的金标准诊断方法。