Study of KUB X-ray in evaluating renal colic in costal Karnataka population

 

Nagaraj Naik

 

Abstract              Background: Renal colic is one of the most common causes of acute abdominal pain in patient’s presentation caused by urolthiasis. It has to be viewed radiologically for location and to diagnose. Method: 50 (fifty) patients of different age groups with renal colic were viewed by x-ray KUB. A detailed history and physical examination was done prior to x-ray. All data was recorded in Performa included history of pain, hematuria, burning micturation, fever, a family history habits etc. Results: 6 (12%) patients were 15-30 years of age, 19 (38%) were between 31-45, 12 (24%0 were aged between 46-69, 9 (18%) were aged between 61-70, 4 (8%) were 71-85 years of age, 17 (34%) had pain 5 (10%) had fever, 3 (6%) had hematuria, 11 (22%) had burring micturation, 39 (78%) were asymptomatic, 9 (18%0 had pain and fever, 2 (4%) had pain and haematuria, 7(14%) had pain burning micturation, 3 (6%) had pain fever haematuria. Conclusion: Urolithiasis is the common cause of renal colic can be effectively diagnosed with x-ray KUB. Almost 90% urinary calculi are radio-opaque and can be diagnosed by plain film radiography of the kidney Ureters and bladder. As it is ideal, a cost effective and affordable to middle class patients.

Keywords: Urolithiasis, KUB, heamaturia, burning micturation, Colic,

 

INTRODUCTION

Renal colic is one of the most common causes of acute abdomen in patients presenting in emergency Renal colic is most commonly caused by urolithiasis ⁽¹⁾. Common locations for stone to become impacted include renal infundibulum, the ureteropelvic junction, the crossing of the iliac vessels and the ureterovesical junction, which is the most constricted area through which stone must pass.² The main purpose of evaluation in patients with renal colic is to confirm the diagnosis to find out the cause and to assess the level and degree of obstruction. In India the life time prevalence of urolithiasis is 5.7% to 10.8%³ but in certain areas the prevalence may increase up to 22.4%.⁴ Urothiatisis constitutes a significant economic burden apart from apart severe pain hence plain KUB study was under taken to locate the renal colic which will be helpful to uro-surgeon to diagnose and treat efficiently.

 

MATERIAL AND METHOD

50 (fifty) patients attending emergency department of Karwar Institute of Medical Sciences, Hospital and Tertiary Hospitals of District Karwar-581301, Karnataka were studied.

Inclusive Criteria: Patients diagnosed as renal colic and referred to radiology were included in the study.

Exclusion Criteria: Children below ten years were excluded from study.

Material and Methods: A detailed history and physical examination of each patient was recorded and confirmed for urolithiasis KUB (kidney ureter and urinary bladder). To avoid repetition of the patients an ID no was given to every patient on enrolling in the study. All data was recorded in a Performa includes history of pain, fever, hematuria, burning micturation, any past history of stone passage, family history of urolithiasis, habit of alcohol, smoking, chewing tobacco was recorded. Duration of study was June-2017 to July-2021.

Statistical analysis: Age, sex, sides of location of urolithiasis, clinical manifestations were classified with percentage. The statistical analysis was performed in SPSS software. The ratio of male and female was 2:1. The present research paper was approved by Ethical committee of Karwar Institute of Medical Sciences (KIMS) Karwar-581301, Karnataka.

DISCUSSION

In the present study the of KUB x-ray in evaluating renal colic in Karnataka patients The age group of the people was between 15 to 85 years – 6 (12%) were aged between 15-30, 19 (38%) were between 31-45, 12 (24%) were between 46-60, 9 (18%) were between 61-70, 4 (8%) were between 71-85 years.36 (72%) males, 14 (28%) females, 21 (42%) had right side renal colic, 29 (58%) had left side (Table-1). 17 (34%) had pain, 5 (10%) had fever, 3 (6%) had hematuria, 11 (22%) had burning micturation, 39 (78%) had asymptomatic renal colic, 9 (18%) had pain with fever, 2 (4%) had pain with haematuria, 7 (14%) had pain, burning micturation, 3 (6%) had pain fever and haematuria (Table-2) (Figure - 1,2,3). These findings are more or less in agreement with previous studies.^5,6,7 In the present study it is observed that, prevalence of renal colic are highest in the young adults i.e. between 31-45 years predominantly in males. In could be due to urolithiasic process in dominant in young adults. The pain and nausea are associated with urethral stones has traditionally been managed with narcotics. However (NSADS) Non-steroidal anti-inflammatory drugs and cyclooxygenase-2 (cox-2) inhibitors also provide effective analgesia by blocking different arteriolar vasodilatation there by reducing dieresis, oedema and urethral smooth muscle stimulation. Because pain is due to renal capsular distentation, intractable pain is controlled by decompressing the obstruction. In rare cases patients may have intractable vomiting. These patients also require decompression and intravenous hydration.⁸ Uric acid stones may be suspected on the basis of history of uric acid stones or gout pure uric acid stones are radiolucent on plain imaging but visible only on USG or CT Uric acid stones are unique in that they can be managed medical.⁹ It is also reported that smoking alcohol consumption, tobacco chewing, significantly increase the risk of urolithiasis, more obese people having BMI between 25 and 29.9 kg /m2 are also more prone to develop kidney stone formation.¹⁰ Hence it can be hypothesized that elevated cholesterol levels enhance the urolithiasis.

 

SUMMARY AND CONCLUSION

The present study of KUB x-ray in evaluation renal colic in Karnataka Patients the present study is cost effective and affordable to middle class patients moreover 90% urinary caliculi are radio-opaque and be diagnosed by plain film radiography of kidney ureter and bladder. Though CT scan is accurate and specific to diagnose renal caliculi its radiation may affect the young growing children. This method cannot be a gold standard method for diagnosing renal caliculi because 8-10% small renal caliculi are radiolucent is not visible on KUB x-ray. Hence USG or CT scan is required to diagnose renal coliculi. Hence ultimately decision of radiologist matters for proper diagnosis.

 

Limitation of study: Owing to tertiary location of present Institute we have small number of patients and limited findings

 

REFERENCES

1. Teichman JM – Clinical practice acute renal colic from urethral calculus N. Eng/Med 2004, 350, 684-93.
2. Haddad MC, Sherieff HS – Renal colic: diagnosis and outcome Radiology 1992, 184; 83-88.
3. Lohiya A, Kant S – Population based estimate urinary stones from Ballabgarh, northern India, Natl. Med. J. India 2017, 30; 198-200.
4. Marak A, Shantibula K – Urolithiasis prevalence and related factors in a rural area of Manipur Int. J. Med. Sci. Public Health 2013, 2; 956-59.
5. Geraghty RM, Cook P – Evaluation of the economic burden of kidney stone disease in the UK – BJU Int. 2020, 125; 586-94.
6. Kirpalani A, Khalilik – Renal colic; comparison of use and outcomes of unenhanced helical CT for emergency investigation. Radiology 2005, 236; 554-8.
7. Miller NL, Evan AP – pathogenesis of renal calculi Urol Clin. North Am. 2007
8. Cordell WH, Larson TA – Indomethacin suppositories verses intravenously titrated morphine for the treatment of ureteric colic Ann. Emerg. Med. 1994, 23; 262-9.
9. Gutman AB, Yu TF – Uric acid nephrolithiasis Am. J. Med. 1968, 45; 756-79.
10. Baatiah NY, Alhazmi RB – Urolithiasis prevalence, risk factors and public awareness regarding dietary and life style habits in Jeddah Urol. Amm. 2020, 12; 57-62.

 

 

 

 

 

 

Policy for Articles with Open Access
Authors who publish with MedPulse International Journal of Anesthesiology (Print ISSN:2579-0900) (Online ISSN: 2636-4654) agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.