Granat Nadav, Alpert Evan Avraham
Department of Emergency Medicine, Rabin Medical Center, Petah Tikva, Israel.
Department of Diagnostic Ultrasound, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel.
Clin Exp Emerg Med. 2024 Jun;11(2):218-223. doi: 10.15441/ceem.23.096. Epub 2024 Jan 29.
Symptomatic urolithiasis is a common cause of emergency department visits, with noncontrast computed tomography considered the imaging gold standard. According to the current guidelines, point-of-care ultrasound (POCUS) is limited to evaluating hydronephrosis as a secondary sign of acute ureteral stones. However, the use of POCUS to detect ureteral stones may lead to decreased radiation to the patient and a more rapid diagnosis. This case series describes 10 patients with suspected symptomatic urolithiasis who were diagnosed accurately by emergency physicians using POCUS to detect obstructive ureteral stones. In three of the cases, POCUS significantly changed the patient's management. This article also describes the proper techniques for the emergency physician to learn to master POCUS for ureteral stone detection.
有症状的尿路结石是急诊科就诊的常见原因,非增强计算机断层扫描被认为是影像学的金标准。根据当前指南,床旁超声(POCUS)仅限于评估肾积水作为急性输尿管结石的次要征象。然而,使用POCUS检测输尿管结石可能会减少患者所受辐射并实现更快诊断。本病例系列描述了10例疑似有症状尿路结石的患者,他们由急诊医生使用POCUS准确诊断出梗阻性输尿管结石。其中3例病例中,POCUS显著改变了患者的治疗方案。本文还描述了急诊医生学习掌握用于检测输尿管结石的POCUS的正确技术。