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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1971 and 1980, 55 children with urolithiasis were assessed and treated. Pediatric urolithiasis accounted for 1:4090 hospital admissions. Forty percent of patients had no identifiable predisposition to urolithiasis. Eight patients presented with hematuria in the absence of renal colic suggesting that pediatric urolithiasis, although uncommon, is an important cause of painless hematuria.
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PMID:Urolithiasis in children. 711 56

We evaluated the stone recurrence rate and long-term renal function in 50 patients with a solitary kidney 60 to 84 months (mean 70.6) after unilateral nephrectomy for urinary tract stone disease. Followup evaluation included a detailed history, physical examination, blood and urine biochemistry studies, urinalysis, urine culture, excretory urography, ultrasonography of the kidney and 131iodine-ortho-iodohippurate renography. The overall stone recurrence rate in unilateral nephrectomy urolithiasis patients was 30% (15 of 50). The mean interval until stone recurrence was 31.1 months (range 6 to 74) and the mean episodes of recurrence were 2.1 times per patient (range 1 to 5). Function of the remnant kidney in most patients was unchanged during followup. However, 2 of the 15 patients with recurrent stones had anuria during the acute attack of renal colic and, thus, required percutaneous nephrostomy urinary diversion, while 1 had proteinuria (3 gm. per day) and progressive renal failure 47 months after nephrectomy. The metabolic stone patients seemed to experience recurrence more easily than metabolic stone patients seemed to experience recurrence more easily than infection stone patients (37% versus 13%) but no statistically significant difference was noted (p = 0.198).
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PMID:The long-term stone recurrence rate and renal function change in unilateral nephrectomy urolithiasis patients. 793 65

Wilson's disease is a rare autosomal recessive disorder that typically presents as hepatic, neurological or psychiatric illness in late adolescence and early adulthood. Although urolithiasis has been documented in as many as 16% of patients with Wilson's disease, only 3 cases have been described that presented with stone disease. We report on a healthy 17-year-old girl who presented with renal colic and a distal ureteral calculus that was subsequently passed. The patient was hospitalized 2 months later with jaundice, ascites, hyperchloremic metabolic acidosis and elevated hepatic enzymes. She was hypophosphatemic and hypouricemic with a low serum ceruloplasmin. Diagnosis was Wilson's disease with Fanconi's syndrome, but despite penicillamine therapy and intensive care support rapidly progressive hepatic failure, coagulopathy and encephalopathy developed. The patient died before emergency liver transplantation. Our case illustrates the role urologists may have in the diagnosis of this rare but potentially treatable disease. Wilson's disease should be considered in the differential diagnosis of any adolescent or young adult with urolithiasis.
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PMID:Wilson's disease presenting as symptomatic urolithiasis: a case report and review of the literature. 805 76

We report a case of a 30-year-old female who had a long-term history of trisilicate-containing antacid intake for gastric discomfort. She had experienced repeated attacks of renal colic. Neither intravenous pyelography nor ureteroscopy could define the presence of calculi. The metabolic evaluations were normal. However, X-ray diffraction revealed a silicate stone. We suggest that the attack of renal colic in those patients with long-term history of trisilicate intake should arouse the possibility of silica urolithiasis.
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PMID:Silica stone--development due to long time oral trisilicate intake. 839

Renal colic mainly due to urolithiasis is one of the most common morbid conditions in urology and commonly seen in the urology emergency clinic. Imaging studies were performed to evaluate the upper urinary tract of 29 patients suffering from renal colic in the 2 years between November, 1994 and October, 1996. After intramuscular injection of the analgesic (pentazocine, 15 mg), all 29 patients were examined by excretory urography (IVP) at the time of the first visit. In some patients abdominal plain computed tomography (CT) scan was performed consecutively even when extravasation of the contrast medium was not seen. Spontaneous peripelvic extravasation was seen in 14 patients (11 males and 3 females) with urolithiasis; 7 of them were diagnosed by IVP, 5 by IVP plus CT scan and 2 with CT scan only. IVP imaging study followed by plain abdominal CT scan is useful even when the contrast medium is not extravasated on IVP in patients suffering from renal colic.
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PMID:[Imaging studies of excretory urography and computed tomography scan for patients suffering from renal colic]. 954 23

Percussion of the kidney as a diagnostic method was first described by John Benjamin Murphy (1857-1916). The test is rapidly elicited, but can cause severe pain. Considering acute pyelonephritis or acute renal colic, it is common practice to perform fist percussion of the kidney, yet its diagnostic value is unknown. Finnish study results in 1998 suggest that in acute renal colic loin tenderness and erythrocyturia are more significant signs than renal tenderness. There is no scientific evidence for determining renal tenderness in diagnosing urinary tract infections and urolithiasis.
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PMID:[Physical diagnosis--pain elicited by percussion in the kidney area]. 1155 74

The diagnosis and initial management of urolithiasis have undergone considerable evolution in recent years. The application of noncontrast helical computed tomography (CT) in patients with suspected renal colic is one major advance. The superior sensitivity and specificity of helical CT allow urolithiasis to be diagnosed or excluded definitively and expeditiously without the potential harmful effects of contrast media. Initial management is based on three key concepts: (1) the recognition of urgent and emergency requirements for urologic consultation, (2) the provision of effective pain control using a combination of narcotics and nonsteroidal anti-inflammatory drugs in appropriate patients and (3) an understanding of the impact of stone location and size on natural history and definitive urologic management. These concepts are discussed with reference to contemporary literature, with the goal of providing tools that family physicians can use in the emergency department or clinic.
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PMID:Diagnosis and initial management of kidney stones. 1131 Jun 48

The objective of this study was to determine whether patients discharged from the Emergency Department (ED) with a proven diagnosis of renal colic require less total evaluation and treatment time if unenhanced helical computed tomography (CT) rather than intravenous urography (IVU) was the diagnostic imaging study used. A retrospective review was undertaken of the medical records of 98 consecutive patients with a final diagnosis of urolithiasis or renal colic evaluated with an unenhanced helical CT scan or an IVU between January 1, 1999, and December 31, 1999. All patients were managed by Emergency Physicians and discharged from the ED. The time the patient was brought to the treatment area, the time the imaging study was ordered, and the time the patient was discharged were recorded. There were 75 patients evaluated with CT scan and 23 patients with an IVU. Patients who underwent unenhanced helical CT scan were in the ED for a mean time of 291 min [95% confidence interval (CI) 266-316] and those who had an IVU were in the ED for an average of 410 min (95% CI 340-481). Use of unenhanced helical CT scan was associated with less total time in the ED compared to IVU for patients with renal colic by a significant mean of 119 min. It is concluded that ED evaluation and treatment time of patients ultimately discharged with a proven diagnosis of renal colic is significantly less when evaluated with unenhanced helical CT scan compared to IVU.
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PMID:Emergency department time for evaluation of patients discharged with a diagnosis of renal colic: unenhanced helical computed tomography versus intravenous urography. 1172 62

Urolithiasis is a common clinical disorder. Its frequency has risen with the development of humanity and varies wirl the country, geographic area, etc. It poses health problems in most countries. The urolithiasis has some potential risk factors such as intrinsic and extrinsic epidemiological, metabolic, physic-chemistry of the urine, mechanics and urinary infection. Our objective in this epidemiological study in a general population was to know the frequency, the potential risk factors, the morbidity, and social and economical impact of the urolithiasis in our subtropical Caribbean country. The prevalence was 4.64% and the annual incidence was 0.1%. Both are with in the estimated range of urolithiasis frequency in the world. It mainly started between 20 and 29 years in both genders. The white (5.2%) and the male (6.36%) patients were the most affected. 40% of all patients had a family history of urolithiasis. It was highly associated with diabetes mellitus, ischaemic cardiopathy, urinary tract infection and arterial hypertension. Stone formation was related to the warmer season. High calcium, protein-purine, carbohydrates and oxalic acid intake together with low fluid intake were closely associated with this disorder. 85% of patients had suffered renal colic and 75% of them more than once. Stone recurrence affected 33.8% of patients and 54.5% of them had more than one recurrence. Procedures for stone removal were needed in 33.8% of subjects. 40% of all patients were admitted to hospital due to urolithiasis morbidity. Non-specific medical treatment had been taken by 49.2% of the patients and specific treatment by none. Urolithiasis in this population was the some as has been reported in others studies. It has shown high frequency, increasing incidence, the same risks factors, high morbidity, and high social and economical impact. The low cost treatment is only taken by half of the patients.
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PMID:[Clinico-epidemiologic study of urolithiasis in a Caribbean urban area]. 1212 23

We determined the diagnostic value of urinalysis and plain films in patients with suspected renal colic presenting to an emergency department (ED). Over a 1-year period, 138 patients presented to the ED during the daytime with suspected renal colic, but for technical reasons the diagnostic modalities used in the study could be completed for only 99 patients, and 34 patients were lost to follow-up. A urinalysis; kidney, ureter, and bladder film; and spiral computed tomography (CT) were performed on each patient. The presence of urinary tract stones was determined by their definite presence on helical CT and/or passage of a stone on clinical follow-up (average follow-up = 3 months). A urinary stone was visualized on spiral CT or passed in the urine in 54 of the patients. Using helical CT findings or passage of a stone as the gold standard, plain radiography had a sensitivity of 69% and specificity of 82%. Urinalysis had a sensitivity of 69% and specificity of 27%. The sensitivity increased to 89% if either test was positive, but the specificity remained low at 27%. The sensitivity and specificity of CT in the diagnosis of urinary stones was 91%. Urinalysis and plain films are much less accurate than helical CT for confirming the diagnosis of acute urolithiasis. Further evaluation of the clinical and cost-effectiveness of helical CT should be done to determine its role in the work-up of these patients.
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PMID:The efficacy of urinalysis, plain films, and spiral CT in ED patients with suspected renal colic. 1267 19


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