Clinical Characteristics of Urolithiasis of Children in Emergency Department

Kim, Hyung Il; Lee, Kang Hyun; Kim, Hyun; Hwang, Sung Oh; Kim, Yun Kwon

Abstract

PURPOSE
The incidence of urolithiasis of children is low (<0.5%), hampering recognition of urolithiasis in children in the emergency department (ED) setting. Thus, delayed diagnosis and misdiagnosis is likely. We investigated the clinical characteristics of urolithiasis in children diagnosed in the ED.
METHODS
From May 2003 to September 2010, among the patients >18-year-of-age who visited the ED with suspicion of urolithiasis, 74 patients were selected. Exclusion criteria were age >18 years, trauma, and only hematuria on urine test. We included 40 patients diagnosed with abdominal ultrasonography, abdominal computed tomography, and IVP. We analyzed age, sex, past history, underlying disease, chief complaint, physical examination, treatment modality, complications, and recurrences of urolithiasis in children. This study was performed retrospectively.
RESULTS
Chief complaints were flank pain (19 cases, 47.5%), gross hematuria (15 cases, 37.5%), and abdominal pain (14 cases, 35%). No patient had abdominal tenderness, the portion of CVA tenderness was high (62.5%). The rate of recurrence was 17.5% (7 cases). Complications of urolithiasis were present in 23 cases (57.5%); among them, the rate of complications was high when a patient had a stone at mid-ureter (p=0.024) and low when the stone was at the renal pelvis (p=0.001).
CONCLUSION
The most common symtom in the patients was flank pain and the rate of CVA tenderness was not high. The common sites of urolithiasis were renal calyx and renal pelvis. The rate of complications was 57.5% and hydroureter was most common. The rate of complication was high when they had the stone at mid-ureter.