Evaluation of the Frequency and Results of Tomography Use in Patients Diagnosed with Renal Colic in The Emergency Department

Objective: An increasing trend in the utilization of computed tomography (CT) imaging has been observed worldwide for patients presenting to emergency departments with acute flank pain and suspected urolithiasis, resulting in significant exposure to ionizing radiation. This study aims to investigate the frequency and indications of CT imaging, as well as the findings and factors influencing these outcomes.
Material and Methods: This is a retrospective, single-center study. Patients who presented to the emergency department with acute-onset flank pain were diagnosed with renal colic and underwent non-contrast CT were included in the study. Symptoms other than flank pain, demographic data, comorbid conditions, vital signs, laboratory results and CT findings. The frequency and indications for CT imaging were analyzed along with the CT results and factors influencing findings.
Results: A total of 232 patients were included in this study. Despite the presence of urolithiasis, CT imaging was performed in 15.9% of the patients, CT was performed due to accompanying abdominal pain with flank pain. In 15% of the cases, no indication for CT imaging could be identified. Across the entire patient group, the rate of detecting abdominal pathologies that could contribute to morbidity aside from urolithiasis was found to be 4.7%, with acute cholecystitis and appendicitis being the most commonly observed pathologies.
Conclusion: Severe flank pain was observed as the most common reason for obtaining CT imaging. A significant portion of patients, however, had no identifiable indication for CT. Avoiding CT imaging may be advisable in young male patients with a known history of stones and hematuria. More up-to-date guidelines are especially needed to reduce unnecessary CT imaging.

Keywords: CT imaging, emergency department, renal colic