• Title/Summary/Keyword: 요관결석

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Usefulness of Color Doppler for Non-dilatational Ureteral Stone (비확장성 요관결석에 대한 컬러 도플러의 유용성)

  • Sim, Hyun-Sun
    • The Journal of the Korea Contents Association
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    • v.17 no.1
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    • pp.120-128
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    • 2017
  • Acute flank pain from urolithiasis is the most common condition in people visiting emergency rooms. This study is to evaluate the usefulness of color Doppler in detecting ureteral stones in patients without hydronephrosis. We performed ultrasonography and retrospective analysis on 161 patients who were suspected of urinary stones through plain radiography of the kidney, ureter, and bladder examination or urine tests that showed positive signs of hematuria. In ultrasonography, a total of 154 (95.6%) cases from the 161 patients were diagnosed with ureteral stones. In color Doppler, ureteral stones with twinkling artifact (TA) in the absence of hydronephrosis was shown in 18 (85.7%) cases of the 21 patients(p<0.001). The use of color Doppler has a high diagnostic efficacy for the detection of indistinguishable stones, non-dilatational ureteral stones, and middle ureter stones.

Transurethral Dormia Dislodging in Patients with Lower Ureteral Stone (하부 요관결석 환자에서 Dormia Stone Dislodger를 이용한 경뇨도적 요관배석술의 의의)

  • Kim, Eun-Gill;Suh, Jun-Kyu;Kim, Young-Soo;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.81-85
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    • 1985
  • Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial Herem we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 4-6 mm, and 33% in 6-10mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained In the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And In the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

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Usefulness of Twinkling Artifacts in Color Doppler Ultrasonography (컬러 도플러 초음파에서 Twinkling artifacts의 유용성)

  • Sim, Hyun-Sun;Kwon, Kyung-Tae
    • The Journal of the Korea Contents Association
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    • v.16 no.10
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    • pp.291-298
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    • 2016
  • The aim of the study was to investigate the diagnostic value of the color Doppler twinkling artifact in disease of urinary system. The intensity of twinkling artifact(TA) with color Doppler was classified into 3 levels, 0(non-TA) to 3(distinct TA). In the in vitro study, acorn jelly with various materials on top was examined using color Doppler at B-mode sonography in a water bath for TA. 31 patients with diagnosis of urinary calculi(renal stones 16, urinary stones 15) based on B-mode sonography were studied in vivo for TA. The materials with rough surfaces such as salt, screw and cubics at B-mode sonography with color Doppler contributed to causing TA. At B-mode sonography without color Doppler 37% of renal stones and 60% of ureter stones were detected. but at B-mode sonography with color Doppler TA was demonstrated for all cases. Superficial roughness of materials affected occurrence of TA at B-mode sonography with color Doppler. Therefore, TA at B-mode sonography without color Doppler could play a role in confident diagnosis of the disease of urinary system.

Extracorporeal Shock Wave Lithotripsy for Proximal Ureter Stone with Complete Obstruction : Analysis of the Appropriate Session for Changing Treatment Modality According to Stone Size (완전 폐색을 동반한 상부 요관 결석에 대한 체외충격파쇄석술 : 결석의 크기에 따른 적절한 치료 전환 시기 분석)

  • Son, Soon-Yong;Lee, Won-Hong
    • Journal of radiological science and technology
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    • v.28 no.4
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    • pp.287-291
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    • 2005
  • To determine the appropriate session for changing treatment modality according to the size of proximal ureter stone with complete obstruction, We analyzed 201 patients with proximal ureter stone primarily treated by Dornier MPL 9000 lithotripter from January, 2002 to August, 2004. Of total 201 patients, the patients without complete obstruction were 142, and with complete obstruction were 59. In the patients without complete obstruction, the accumulative stone free rate of the first, second, and third session were 68.3%, 86.6%, and 94.4%, respectively. The accumulative stone free rate according to the stone size at third session were 100%, 90.5%, 00.0% in stones less than 10 mm, 10 to less than 20 mm, and larger than or 20 mm, respectively. In the patients with complete obstruction, the accumulative stone free rate of the first, second, and third session were 44.1%, 66.1%, and 76.3%, respectively. The accumulative stone free rate according to the stone size at third session were 100%, 65.5%, 33.3% in stones less than 10 mm, 10 to less than 20 mm, and larger than or 20 mm, respectively. In our study, the size of proximal ureter stone with complete obstruction influenced noticeably on the success rate of extracorporeal shock wave lithotripsy (ESWL). We propose that the proximal ureter stones larger than or 10 mm with complete obstruction are treated by ureteroscopic manipulation than ESWL as the first line treatment modality.

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Hypertensive Encephalopathy in a 10-year-old Boy with Ureteral Stone (10세 남아에서 생긴 요관 결석에 의한 고혈압성 뇌병증)

  • Kim Yong-Joo;Kang Hoon-Chul;Koo Ja-Wook
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.51-56
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    • 2004
  • Hypertensive encephalopathy is an acute neurologic syndrome that occurs in association with abrupt and marked elevation of blood pressure and is characterized by headache, vomiting, seizure, visual disturbances and altered mental status. Hypertensive encephalopathy is most commonly associated with renal disease in children, including acute glomerulonephritis, reno-vascular hypertension, and end-stage renal disease. Hypertensive encephalopathy associated with nephrolithiasis has not been reported. We have experienced a 10-year-old boy with hypertensive encephalopathy associated with ureteral stone.

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Analysis of Twinkling Artifacts Caused by Kidney Stones on Abdominal Ultrasound (복부 초음파 검사에서 신장결석으로 인해 발생되는 Twinkling 인공물에 관한 분석)

  • Kim, Ju-Hee;Jang, Hyon-Chol;Cho, Pyong-Kon
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.637-642
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    • 2021
  • Kidney stones are largely classified into kidney stones, ureter stones, and urolithiasis depending on the location of their occurrence. Therefore, in this study, from January 2019 to June 2021, kidney stones found in 112 patients with flank pain or who visited for abdominal ultrasonography at a general hospital located in Daegu were diagnosed with urolithiasis. We wanted to investigate the effect on twinkling artifacts. As a result of the study, the incidence of twinkling artifacts due to kidney stones was relatively high in the longitudinal scan among the scan methods. As the number of kidney stones increased, the incidence of twinkling artifacts increased by 1.296 times (p<0.05). As the kidney stone size increased, the incidence of twinkling artifacts increased by 0.086-fold (p<0.05). It was found that the number and size of kidney stones are factors affecting twinkling artifacts. Since the effect of kidney stones on twinkling artifacts is related to the number and size of kidney stones, continuous attention should be paid to helping the detection of kidney stones by using variables affecting twinkling artifacts.

The Optimal Shock Intensity and C-arm Total Running Time in Patients with Inferior Ureter Stones during Electromagnetic of ESWL (전자기식 체외충격파쇄석술시 하부요관 결석 환자에 대해 적합한 충격강도와 C-arm 총 가동시간)

  • Park, Jeong Kyu;Cho, Euy Hyun
    • Journal of the Korean Society of Radiology
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    • v.8 no.7
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    • pp.461-466
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    • 2014
  • The advantages and disadvantages of the various models of crushed ESWL (Extracorporeal Shock Wave Lithotripsy) and their various side effects due to pre-treatment have been reported. We look for the appropriate intensity of the shock wave in the electromagnetic ESWL treatment of patients with lower Inferior Ureter Stones and measure the total running time of C-arm saw. This study is based on the January-June 2014 launch of 65 patients of C university hospital located in Gyeongbuk, who conducted ESWL without pre-treatment. Patients are composed of 48 male and 17 female which were more common in men, while the most common age is 50s. The occurrence of lower urinary tract stones were left and they were more absent than 5mm in size in 39 of the most common. Optimal intensity is one of the suitable intensity of pain, and it is possible to switch the strength of impact to C if one appeals pain. In addition, the C-arm of the total operating time showed $241.73{\pm}30.37$ seconds, which is the size of the lower urinary tract that showed a significant difference (p <0.05). Therefore, ESWL treatment without pre-enforce treatment, the standard for the impact frequency and impact strength depending on the site of ureteral stones is required. The standard for total operating time of C-arm generated for ureteral stones is needed in order to reduce radiation exposure, and the standard for the total operating time for the criteria is needed depending on the site in order to minimize the exposure.

Acute Kidney Injury and Postobstructive Diuresis Caused by a 4 mm Urinary Calculus (작은 요로 결석에 의한 급성 신후성 신부전 및 폐쇄 후 이뇨 1례)

  • Jung, Eui Seok;Yang, Eun Mi;Kim, Chan Jong
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.117-121
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    • 2013
  • Urinary obstructions from ureteral calculi are one of the causes of postrenal acute kidney injury (AKI). Here we present a case of AKI caused by a 4 mm ureteral calculus with postobstructive diuresis following the spontaneous passage of the calculus. A 13-year-old girl who underwent nephrectomy for the removal of a neuroblastoma eight years previously, visited our institution because anuria had developed over the preceding five days. The serum creatinine level was elevated at 13.4 mg/dL. Radiological examinations showed the right solitary kidney with moderate hydronephrosis and a 4 mm calculus in the upper right ureter. The patient immediately underwent hemodialysis. After the ureteral calculus was passed spontaneously on day 2 of hospitalization, urinary output increased to more than 5,200 mL per day. Intravenous fluid replacement with careful monitoring of weight, intake, output, and serum and urine electrolytes was performed. On day 5 of hospitalization, the patient's condition stabilized.

Clinical Experiences of the Ureteroscopic Management for the Lower Ureteral Stone (하부요관결석에 대한 요관경하배석술)

  • Mo, Seong-Jong;Kim, Young-Soo;Suh, Jun-Kyu;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.97-102
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    • 1990
  • Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62(83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents(65 cases). Of 57 smaller calculi than 1Cm(radiographic largest diameter) 50(88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications durinf or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.

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Radiation Dose during Fluoroscopy at the Organ from Extracorporeal Shock Wave Lithotripsy (체외충격파쇄석술에서 투시 시 주요 장기별 방사선 피폭선량)

  • Moon, Sung-Ho;Jung, Hong-Ryang;Lim, Cheong-Hwan
    • The Journal of the Korea Contents Association
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    • v.10 no.5
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    • pp.343-350
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    • 2010
  • We measured the radiation exposure for 55 persons (male: 36, female: 19) who was diagnosed with kidney and ureter stones and received ESWL. The absorbed dose was measured at the organ which is expected to absorb relatively much radiation (kidney, bladder, liver). The radiation dose measurement voltage 80kVp, current of 5mA as a fixed model of the human body by using the Rando phantom with Radiophotoluminescent Glass Dosimeter. Absorbed dose was measured for two times (5 minute and 10 minute, each) and converted to effective dose. Mean number of treatment was 1.8 times (1~4) per patient was the mean time of radiation exposure533 seconds (248-2516). For the treatment of right renal stone, the effective dose of right kidney, left kidney, liver and bladder was 2.458mSv, 0.152mSv, 1.404 mSv and 0.019mSv, respectively. For the treatment of left renal stone, the effective dose of right kidney, left kidney, liver and bladder was 2.496mSv, 0.252mSv, 0.178 mSv, and 0.017mSv, respectively. For the treatment of distal ureter stone, the effective dose of right kidney, left kidney and bladder was 0.009mSv, 0.01mSv and 3.742mSv, respectively.