[Diagnostic reliability of echography in ureteral lithiasis]

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Ureteral stones (ureteral lithiasis) are a common cause of acute abdominal pain.
• Accurate localization of ureteral stones is crucial for effective management and treatment planning.
• Ultrasound (US) is a widely available imaging modality, but its diagnostic reliability for ureteral stones has been debated.

Purpose of the Study:

• To evaluate the diagnostic reliability of ultrasound in localizing ureteral stones.
• To assess the clinical presentation and management of patients with ureteral lithiasis diagnosed via ultrasound.
• To highlight the role of ultrasonographic follow-up in detecting missed ureteral stones.

Main Methods:

• Retrospective analysis of 119 patients with suspected ureteral lithiasis.
• Detailed review of ultrasonographic findings, including stone localization and detection rates.
• Correlation of imaging results with clinical presentation, symptomatology, and subsequent treatment.

Main Results:

• Ultrasound successfully localized ureteral stones in 82.3% of patients, with an improved rate of 89.4% in the last 85 consecutive cases.
• Atypical presentations mimicking appendicitis, intestinal obstruction, or pancreatitis were observed in 10 patients.
• Stones were incidentally found in 5 asymptomatic individuals, with 80% located in the proximal or juxtavesical ureter.
• Ultrasonographic follow-up identified stones in 6 cases initially reported as negative.
• Eight patients required extracorporeal shock wave lithotripsy (ESWL) for treatment.

Conclusions:

• Ultrasound is a reliable tool for diagnosing ureteral lithiasis, particularly with increasing experience.
• The modality is valuable for identifying stones even in cases with atypical symptoms or in asymptomatic patients.
• Ultrasonographic follow-up can improve diagnostic yield, and findings guide the need for further interventions like ESWL.