Tomografía de abdomen simple en la litiasis renal y vías urinarias

[Unenhanced abdominal tomography in renal lithiasis and urinary tract]

Rolando Reyna1, Ana Lía Diez2

1. Hospital Santo Tomás, Panamá, Panamá; 2. Hospital del Niño, Panamá Panamá, Panamá;

Publicado: 2022-08-30

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Resumen

La litiasis urinaria representa una patología importante en la práctica médica y requiere de un abordaje multidisciplinario. Su incidencia es del 10% y afecta a un grupo de edad extenso, con factores que pueden influir en su aumento en determinados lugares. Su diagnóstico aparece como hallazgo en controles rutinarios de salud o a través del síndrome de cólico renal, cuadro característico y de consulta frecuente en los servicios de urgencia. La tomografía computarizada para el estudio de la litiasis renal puede brindar información más detallada. Tiene una sensibilidad, especificidad y seguridad mucho mayor que la radiografía simple del abdomen y que la de la urografía excretora. Los hallazgos directos incluyen el cálculo en el uréter, dilatación ureteral por arriba del cálculo, signo del halo con densidad de tejido blando rodeando al cálculo y los indirectos son dilatación del sistema colector y del uréter, aumento de volumen del riñón y edema perinefrítico.


Abstract

Urinary lithiasis represents an important pathology in medical practice and requires a multidisciplinary approach. Its incidence is 10% and affects a large age group, with factors that can influence its increase in certain places. Its diagnosis appears as a finding in routine health checks or through renal colic syndrome, a characteristic condition and frequent consultation in the emergency services. Computed tomography for the study of renal lithiasis can provide more detailed information. It has a sensitivity, specificity and safety much greater than simple radiography of the abdomen and of excretory urography. Direct findings include calculus in the ureter, ureteral dilation above the calculus, halo sign with soft tissue density surrounding the calculus, and indirect findings include dilatation of the collecting and ureter system, increased kidney volume, and peri nephritic edema.

Biografía del autor/a

Rolando Reyna, Hospital Santo Tomás, Panamá, Panamá

Medico radiologo

Citas

[1] Ricardo Susaeta, David Benavente, Fernando Marchant, Renato Gana. Diagnóstico y manejo de Litiasis renales en adultos y niños. REV. MED. CLIN. CONDES 2018; 29(2) 197-212.DOI: https://doi.org/10.1016/j.rmclc.2018.03.002

[2] Jaime Saavedra Abril, Kenji Kimura Fujikami, Miguel Stoopen, Gerardo Villegas López, Alcántara-Cervantes J. Diagnóstico de litiasis renoureteral con Tomografía Multicorte. Anales de Radiología México 2002; 4:591-594.

[3] Anderson K, Smith R. CT for the evaluation of flank pain. Journal of endourology 2001; 15:25-29DOI: https://doi.org/10.1089/08927790150500917

[4] Heneghan JP, Dalrymple NC, Verga M, et al. Soft-tissue "rim" sign in the diagnosis of ureteral calculi with use of unenhanced helical CT. Radiology 1997; 202:709-711DOI: https://doi.org/10.1148/radiology.202.3.9051021

[5] Smith R, Verga M, Dalrymple NC, et al. Acute ureteral obstruction: value of secondary signs of helical unenhanced CT. AJR Am Roentgenology 1996;167:1109-1113DOI: https://doi.org/10.2214/ajr.167.5.8911160

[6] Phillip M. Cheng, Paymann Moin, Matthew D. Dunn, William D. Boswell, and Vinay A. Duddalwar. What the Radiologist Needs to Know About Urolithiasis: Part 1. Pathogenesis, Types, Assessment, and Variant Anatomy. American Journal of Roentgenology 2012 198:6, W540-W547.DOI: https://doi.org/10.2214/AJR.10.7285

[7] Phillip M. Cheng, Paymann Moin, Matthew D. Dunn, William D. Boswell, and Vinay A. Duddalwar. What the Radiologist Needs to Know About Urolithiasis: Part 2. CT Findings, Reporting, and Treatment American Journal of Roentgenology 2012 198:6, W548-W554.DOI: https://doi.org/10.2214/AJR.11.8462

[8] Avinash R. Kambadakone, Brian H. Eisner, Onofrio Antonio Catalano, Dushyant V. Sahani. New and Evolving Concepts in the Imaging and Management of Urolithiasis: Urologists' Perspective. RadioGraphics 2010; 30:603-623.DOI: https://doi.org/10.1148/rg.303095146

[9] Bellin MF, Renard-Penna R, Conort P, et al. Helical CT evaluation of the chemical composition of urinary tract calculi with a discriminant analysis of CT-attenuation values and density. Eur Radiol 2004; 14:2134-2140.DOI: https://doi.org/10.1007/s00330-004-2365-6

[10] Papatsoris AG, Varkarakis I, Dellis A, Deliveliotis C. Bladder lithiasis: from open surgery to lithotripsy. Urol Res. 2006 Jun;34(3):163-7.DOI: https://doi.org/10.1007/s00240-006-0045-5

[11] Leslie SW, Sajjad H, Murphy PB. Bladder Stones. [Updated 2022 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441944/

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