Skip to main content
SpringerLink
Log in

Urological Emergencies

  • Chapter
CT of the Acute Abdomen

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 2345 Accesses

Abstract

Renal colic pain due to an obstructing stone is the main renal cause of acute flank pain; however, other causes may be responsible for the same clinical findings, including acute pyelonephritis, acute vascular conditions, and hemorrhage. The purpose of this review is to describe the differential diagnosis, the CT findings and pitfalls, and the role and impact of CT in the diagnosis and management of the renal causes of acute flank pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahmad NA, Ather MH, Rees J (2003) Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic. BMC Urol 3:2

    Article  PubMed  Google Scholar 

  • Ahmed J, Mallick IH, Ahmad SM (2009) Rupture of urinary bladder: a case report and review of literature. Cases J 2:7004

    Article  PubMed  Google Scholar 

  • Bolderman R, Oyen R, Verrijcken A et al (2006) Idiopathic renal infarction. Am J Med 119:356.e9–12

    Article  PubMed  Google Scholar 

  • Boridy IC, Kawashima A, Goldman SM, Sandler CM (1999) Acute ureterolithiasis: nonenhanced helical CT findings of perinephric edema for prediction of degree of ureteral obstruction. Radiology 213:663–667

    PubMed  CAS  Google Scholar 

  • Browne RFJ, Zwirewich C, Torreggiani WC (2004) Imaging of urinary tract infection in the adult. Eur Radiol 14:168–183

    Article  Google Scholar 

  • Catalano O, Nunziata A, Altei F et al (2002) Prima, helical CT versus selective helical CT after unenhanced radiography and sonography. AJR Am J Roentgenol 178:379–387

    PubMed  Google Scholar 

  • Craig WD, Wagner BJ, Travis MD (2008) Pyelonephritis: radiologic-pathologic review. Radiographics 28:255–276

    Article  PubMed  Google Scholar 

  • D’Ambrosio N, Friedman B, Siegel D et al (2007) Spontaneous isolated dissection of the celiac artery: CT findings in adults. AJR Am J Roentgenol 188:W506–W511

    Article  PubMed  Google Scholar 

  • DeFoor W, Tackett L, Minevich E, Wacksman J, Sheldon C (2003) Risk factors for spontaneous bladder perforation after augmentation cystoplasty. Urology 62:737–741

    Article  PubMed  Google Scholar 

  • Ege G, Akman H, Kuzucu K, Yildiz S (2003) Acute ureterolithiasis: incidence of secondary signs on unenhanced helical CT and influence on patient management. Clin Radiol 58:990–994

    Article  PubMed  CAS  Google Scholar 

  • Fultz PJ, Hampton WR, Totterman SM (1993) Computed tomography of pyonephrosis. Abdom Imaging 18:82–87

    Article  PubMed  CAS  Google Scholar 

  • Gentle DL, Stoller ML, Jarrett TW et al (1997) Protease inhibitor-induced urolithiasis. Urology 50:508–511

    Article  PubMed  CAS  Google Scholar 

  • Grayson DE, Abbott RM, Levy AD, Sherman PM (2002) Emphysematous infections of the abdomen and pelvis: a pictorial review. Radiographics 22:543–561

    PubMed  Google Scholar 

  • Hazanov N, Somin M, Attali M et al (2004) Acute renal embolisms. Forty-four cases of renal infarction in patients with atrial fibrillation. Medicine 83:292–299

    Article  PubMed  Google Scholar 

  • Joffe SA, Servaes S, Okon S, Horowitz M (2003) Multi-detector row CT urography in the evaluation of hematuria. Radiographics 23:1441–1456

    Article  PubMed  Google Scholar 

  • Kamel IR, Berkowitz JF (1996) Assessment of the cortical rim sign in posttraumatic renal infarction. J Comput Assist Tomogr 20:803–806

    Article  PubMed  CAS  Google Scholar 

  • Kanofskh JA, Lepor H (2007) Spontaneous renal artery dissection. Urology 9:156–160

    Google Scholar 

  • Katz DS, Scheer M, Lumerman JH et al (2000) Alternative or additional diagnoses on unenhanced helical computed tomography for suspected renal colic: experience with 1000 consecutive examinations. Urology 56:53–57

    Article  PubMed  CAS  Google Scholar 

  • Kawashima A, Sandler CM, Ernst RD et al (1999) Imaging of nontraumatic hemorrhage of the adrenal gland. Radiographics 19:949–963

    PubMed  CAS  Google Scholar 

  • Kawashima A, Sandler CM, Emst RD et al (2000) CT evaluation of renovascular disease. Radiographics 20:1321–1340

    PubMed  CAS  Google Scholar 

  • Levenson RB, Singh AK, Novelline RA (2008) Fournier gangrene: role of imaging. Radiographics 28:519–528

    Article  PubMed  Google Scholar 

  • Levine E, Grantham JJ (1985) High-density renal cysts in autosomal dominant polycystic kidney disease demonstrated by CT. Radiology 154:477–482

    PubMed  CAS  Google Scholar 

  • Levine J, Neitlich J, Smith RC (1999) The value of prone scanning to distinguish ureterovesical junction stones from ureteral stones that have passed into the bladder: leave no stone unturned. AJR Am J Roentgenol 172:977–981

    PubMed  CAS  Google Scholar 

  • Liach F, Paper S, Massry SG (1980) The clinical spectrum of renal vein thrombosis: acute and chronic. Am J Med 69:819–827

    Article  Google Scholar 

  • Liu CC, Li CC, Shih MC et al (2003) Matrix stone. J Comput Assist Tomogr 27:810–813

    Article  PubMed  Google Scholar 

  • Luchs JS, Katz DS, Lane MJ et al (2002) Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results. Urology 59:839–842

    Article  PubMed  Google Scholar 

  • Memarsadeghi M, Heinz-Peer G, Helbich TH et al (2005) Unenhanced multidetector row CT in patients suspected of having urinary stone disease: effect of section width on diagnosis. Radiology 235:530–536

    Article  PubMed  Google Scholar 

  • Memarsadeghi M, Schaefer-Prokop C, Prokop M et al (2007) Unenhanced MDCT in patients with suspected urinary stone disease: do coronal reformations improve diagnostic performance? AJR Am J Roentgenol 189:60–64

    Article  Google Scholar 

  • Muraoka N, Sakai T, Kimura H et al (2008) Rare causes of hematuria associated with various vascular diseases involving the upper urinary tract. Radiographics 28:855–867

    Article  PubMed  Google Scholar 

  • Narlawar RS, Raut AA, Nager A et al (2004) Imaging features and guided drainage in emphysematous pyelonephritis: a study of 11 cases. Clin Radiol 59:192–197

    Article  PubMed  CAS  Google Scholar 

  • Poletti PA, Platon A, Rutschmann OT et al (2006) Abdominal plain film in patients admitted with clinical suspicion of renal colic: should it be replaced by low-dose computed tomography? Urology 67:64–68

    Article  PubMed  Google Scholar 

  • Poletti PA, Platon A, Rutschmann OT et al (2007) Low-dose versus standard-dose CT protocol in patients with clinically suspected renal colic. AJR Am J Roentgenol 188:927–933

    Article  PubMed  Google Scholar 

  • Prando A, Prando D, Prando P (2006) Renal cell carcinoma: unusual imaging manifestations. Radiographics 26:233–244

    Article  PubMed  Google Scholar 

  • Press SM, Smith AD (1995) Incidence of negative hematuria in patients with acute urinary lithiasis presenting to the emergency room with flank pain. Urology 45:753–757

    Article  PubMed  CAS  Google Scholar 

  • Ramamoorthy SL, Vasquez JC, Taft PM et al (2002) Nonoperative management of acute spontaneous renal artery dissection. Ann Vasc Surg 16:157–162

    Article  PubMed  Google Scholar 

  • Rucker CM, Menias CO, Bhalla S (2004) Mimics of renal colic: alternative diagnoses at unenhanced helical CT. Radiographics 24:S11–S33

    Article  PubMed  Google Scholar 

  • Segura JW, Preminger GM, Assimos DG et al (1997) Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. J Urol 158:1915–1921

    Article  PubMed  CAS  Google Scholar 

  • Stunell H, Buckley O, Feeney J et al (2007) Imaging of acute pyelonephritis in the adult. Eur Radiol 17:1820–1828

    Article  PubMed  CAS  Google Scholar 

  • Talner LB, Davidson AJ, Lebowitz RL et al (1994) Acute pyelonephritis: can we agree on terminology? Radiology 192:297–305

    PubMed  CAS  Google Scholar 

  • Talner L, Vaughan M (2003) Nonobstructive renal causes of flank pain: findings on noncontrast helical CT (CT KUB). Abdom Imaging 28:210–216

    Article  PubMed  CAS  Google Scholar 

  • Tamm EP, Silverman PM, Shuman WP (2003) Evaluation of the patient with flank pain and possible ureteral calculus. Radiology 228:319–329

    Article  PubMed  Google Scholar 

  • Teichman JMH (2004) Acute renal colic from ureteral calculus. N Engl J Med 350:684–693

    Article  PubMed  CAS  Google Scholar 

  • Thomas AA, Lane BR, Thomas A et al (2007) Emphysematous cystitis: a review of 135 cases. Journal Compilation 100:17–20

    Google Scholar 

  • Vieweg J, The C, Freed K et al (1998) Unenhanced helical computerized tomography for the evaluation of patients with acute flank pain. J Urol 160:679–684

    Article  PubMed  CAS  Google Scholar 

  • Wan YL, Lee TY, Bullard MJ et al (1996) Acute gas-producing bacterial renal infection: correlation between imaging findings and clinical outcome. Radiology 198:433–438

    PubMed  CAS  Google Scholar 

  • Wong-You Cheong J, Woodward PJ, Manning MA, Davis CJ (2006) From the archives of the AFIP: inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation. Radiographics 26:1847–1868

    Article  PubMed  Google Scholar 

  • Yanar H, Taviloglu K, Ertekin C et al (2006) Fournier’s gangrene: risk factors and strategies for management. World J Surg 30:1750–1754

    Article  PubMed  Google Scholar 

  • Zhang JQ, Fielding JR, Zou KH (2002) Etiology of spontaneous perirenal hemorrhage: a meta-analysis. J Urol 167:1593–1596

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Imaging, Hôpital Lapeyronie, Montpellier Cedex 5, 34295, France

    Patrice Taourel

  2. Department of Urology, Hôpital Lapeyronie, Montpellier Cedex 5, 34295, France

    Rodolphe Thuret

Authors
  1. Patrice Taourel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rodolphe Thuret
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrice Taourel .

Editor information

Editors and Affiliations

  1. Imagerie Médicale, Hôpital Lapeyronie, avenue du Doyen Gaston Giraud 371, Montpellier CX 5, 34295, France

    Patrice Taourel

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Taourel, P., Thuret, R. (2010). Urological Emergencies. In: Taourel, P. (eds) CT of the Acute Abdomen. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2010_88

Download citation

  • DOI: https://doi.org/10.1007/174_2010_88

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-89231-1

  • Online ISBN: 978-3-540-89232-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation