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Emergency computed tomography in acute renal colic is essential for correct diagnosis and shortens time to treatment and stone-free status

Utter, Maria LU orcid ; Forsvall, Andreas LU orcid ; Altmark, Fredrik LU ; Thiel, Tomas LU ; Torbrand, Christian LU and Wagenius, Magnus LU orcid (2026) In Central European Journal of Urology 79(1). p.42-48
Abstract

Introduction This study aimed to evaluate the clinical impact of implementing routine emergency computed tomography (eCT) for all patients presenting with suspected acute renal colic at the emergency department (ED). Material and methods We did a retrospective observational study of all patients who underwent eCT for suspected acute renal colic at the ED in Helsingborg between May 9, 2023 and May 8, 2024 and compared with a 2019/2020 cohort not using routine eCT. Results Of 66,540 ED visits during the study period, 1,566 patients underwent eCT for suspected acute renal colic; 1,261 were included in the analysis after exclusions. In 57% of patients, no symptomatic stone was identified; nevertheless, one fifth required hospital admission... (More)

Introduction This study aimed to evaluate the clinical impact of implementing routine emergency computed tomography (eCT) for all patients presenting with suspected acute renal colic at the emergency department (ED). Material and methods We did a retrospective observational study of all patients who underwent eCT for suspected acute renal colic at the ED in Helsingborg between May 9, 2023 and May 8, 2024 and compared with a 2019/2020 cohort not using routine eCT. Results Of 66,540 ED visits during the study period, 1,566 patients underwent eCT for suspected acute renal colic; 1,261 were included in the analysis after exclusions. In 57% of patients, no symptomatic stone was identified; nevertheless, one fifth required hospital admission for alternative diagnoses. A radiologically proven stone explaining their symptoms was found in 43% of patients. Compared with the 2019/2020 cohort, the 2023/2024 cohort had more treatments (33% vs 21%), and significantly shorter time to both treatment (p = 0.01) and clinical closure (p <0.001). Stone size, location, type of treatment and number of visits to the ED were comparable between the two cohorts. Conclusions Acute renal colic in its clinical presentation appeared to be less diagnostically reliable than previously assumed. The use of eCT ensured accurate diagnosis of urolithiasis, significantly shortened time to treatment, and to a stone-free patient as well as reduced the use of stents. We propose that eCT should be implemented as a routine procedure in the management of acute renal colic.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute renal colic, computed tomography, emergency medicine, urolithiasis, urology
in
Central European Journal of Urology
volume
79
issue
1
pages
7 pages
publisher
Polish Urological Association
external identifiers
  • pmid:41821911
  • scopus:105030662008
ISSN
2080-4806
DOI
10.5173/ceju.2025.0245
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2026, Polish Urological Association. All rights reserved.
id
3eb96a4a-f036-4d8c-8a2c-5b33651f1761
date added to LUP
2026-04-20 13:27:33
date last changed
2026-06-29 19:54:06
@article{3eb96a4a-f036-4d8c-8a2c-5b33651f1761,
  abstract     = {{<p>Introduction This study aimed to evaluate the clinical impact of implementing routine emergency computed tomography (eCT) for all patients presenting with suspected acute renal colic at the emergency department (ED). Material and methods We did a retrospective observational study of all patients who underwent eCT for suspected acute renal colic at the ED in Helsingborg between May 9, 2023 and May 8, 2024 and compared with a 2019/2020 cohort not using routine eCT. Results Of 66,540 ED visits during the study period, 1,566 patients underwent eCT for suspected acute renal colic; 1,261 were included in the analysis after exclusions. In 57% of patients, no symptomatic stone was identified; nevertheless, one fifth required hospital admission for alternative diagnoses. A radiologically proven stone explaining their symptoms was found in 43% of patients. Compared with the 2019/2020 cohort, the 2023/2024 cohort had more treatments (33% vs 21%), and significantly shorter time to both treatment (p = 0.01) and clinical closure (p &lt;0.001). Stone size, location, type of treatment and number of visits to the ED were comparable between the two cohorts. Conclusions Acute renal colic in its clinical presentation appeared to be less diagnostically reliable than previously assumed. The use of eCT ensured accurate diagnosis of urolithiasis, significantly shortened time to treatment, and to a stone-free patient as well as reduced the use of stents. We propose that eCT should be implemented as a routine procedure in the management of acute renal colic.</p>}},
  author       = {{Utter, Maria and Forsvall, Andreas and Altmark, Fredrik and Thiel, Tomas and Torbrand, Christian and Wagenius, Magnus}},
  issn         = {{2080-4806}},
  keywords     = {{acute renal colic; computed tomography; emergency medicine; urolithiasis; urology}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{42--48}},
  publisher    = {{Polish Urological Association}},
  series       = {{Central European Journal of Urology}},
  title        = {{Emergency computed tomography in acute renal colic is essential for correct diagnosis and shortens time to treatment and stone-free status}},
  url          = {{http://dx.doi.org/10.5173/ceju.2025.0245}},
  doi          = {{10.5173/ceju.2025.0245}},
  volume       = {{79}},
  year         = {{2026}},
}