Ureteral Obstruction and Ureteral Jet Identification-A Case Report

Area of Science:

• Emergency Medicine
• Radiology
• Nephrology

Background:

• Point-of-care ultrasound (POCUS) is a valuable tool for evaluating flank pain in emergency settings.
• POCUS can expedite diagnosis and reduce reliance on abdominal CT scans, thereby minimizing radiation exposure.
• Ureteral obstruction is a common cause of acute flank pain, necessitating prompt and accurate diagnosis.

Purpose of the Study:

• To highlight the diagnostic utility of identifying ureteral jets using POCUS in cases of suspected ureteral obstruction.
• To demonstrate how POCUS findings can guide further diagnostic workup for flank pain.
• To emphasize the importance of subtle ultrasound findings in improving diagnostic precision.

Main Methods:

• A case report detailing the presentation and diagnostic process of a 77-year-old female with acute flank pain.
• Utilized point-of-care ultrasound to assess for ureteral jets.
• Confirmed diagnosis with computed tomography (CT).

Main Results:

• Point-of-care ultrasound revealed an absent right-sided ureteral jet.
• The absence of the ureteral jet was indicative of ureteral obstruction.
• Computed tomography confirmed the diagnosis of ureteral obstruction.

Conclusions:

• The identification of ureteral jets on POCUS is a valuable indicator for diagnosing ureteral obstruction.
• POCUS can serve as an effective first-line imaging modality for flank pain, potentially obviating the need for CT.
• Recognizing specific POCUS findings like absent ureteral jets enhances diagnostic accuracy and expedites patient management.