What happens to patients who have a negative CT KUB for ureteric colic?
BAUS ePoster online library. Jimie J. Jun 25, 2019; 259476; P11-2
Mr. Joachim Jimie
Mr. Joachim Jimie
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Abstract
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INTRODUCTION

CT KUB is the gold standard in diagnosing ureteric colic. Timely diagnosis allows urologists to reassure patients that no acute intervention is required if the stone is small, pain controlled and there is no sepsis / AKI. If CT KUB excludes urolithiasis then urology admission may be avoided altogether. We aim to assess the outcomes of patients who present to A&E with suspected renal colic and no evidence of ureteric calculi on immediate CT KUB.

Patients and Method:

Retrospective review of patients undergoing immediate CT KUB in A&E for suspected ureteric colic between 01/01/2016 & 31/12/2017.

Results

850 CT KUB examinations were performed.

545 (64%) were negative for ureteric stones. 90 (11%) were admitted with an alternative diagnosis to a different speciality (69 general surgery, 11 O&G, 7 medicine). 99 (12%) patients were admitted to urology (pyelonephritis, recently passed stone, renal stones). 3 (0.4%) life threatening emergencies were diagnosed (AAA, aortic dissection and spontaneous renal artery bleed). 356 (42%) patients were discharged from A&E.

The remaining 275 (32%) showed a ureteric stone [median stone size = 4mm]. 173 of these were admitted (20%). Median LOS = 1 night. 102 (13%) were discharged from A&E.167 (61%) had successful stone passage without definitive treatment.

In total 458 (54%) patients were discharged from A&E following their urgent CT KUB and 68% patients avoided urology admission.

Conclusion

Immediate CT KUB in A&E helps facilitate immediate discharge in 54% of patients. Urology admission was avoided in 68% of cases.
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