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J Korean Soc Emerg Med > Volume 35(3); 2024 > Article
Journal of The Korean Society of Emergency Medicine 2024;35(3): 239-245.
요로결석에 의한 급성 신우신염 환자의 컴퓨터단층촬영 소견의 가짓수에 따른 임상양상 및 패혈증과의 관계
김근석1 , 진상찬2 , 박진욱1
1대구파티마병원 응급의학과
2계명대학교 의과대학 동산의료원 응급의학교실
The clinical features and relationship with sepsis according to the number of computed tomography findings in patients with acute pyelonephritis with urolithiasis
Geunseok Kim1 , Sangchan Jin2 , Jinwook Park1
1Department of Emergency medicine, Daegu Fatima Hospital, Daegu, Korea
2Department of Emergency Medicine, Dongsan Medical Center, Keimyoung University School of Medicine, Daegu, Korea
Correspondence  Sangchan Jin ,Tel: 053-258-7330, Fax: 053-258-7130, Email: jchan98@hanmail.net,
Received: August 7, 2023; Revised: November 11, 2023   Accepted: October 30, 2023.  Published online: June 30, 2024.
Urolithiasis is obstructive uropathy that can progress to acute pyelonephritis by retrograde urinary tract infection. This study aimed to assess the clinical features of acute pyelonephritis with urolithiasis based on the computed tomography (CT) findings.
The medical records of patients who visited the emergency room were reviewed retrospectively from January 1, 2018, to January 31, 2021. This study investigated 109 patients (over 14 years old) diagnosed with acute pyelonephritis by kidney computed tomography. In the patient with acute pyelonephritis with urolithiasis, there were some findings like wedge-shaped hypodensity, kidney enlargement, perinephric fat stranding, pelvicalyceal wall thickness and enhancement, Gerota’s fascia thickness, and delayed excretion of contrast. The subjects were classified into two groups according to the number of CT findings: less than three CT findings group (group 1) and three or more CT findings group (group 2).
A higher incidence of hypotension, tachycardia, and sepsis was observed in group 2 than in group 1 (all P<0.05). Furthermore, the high sensitivity C-reactive protein level was also significantly higher than group 1. The number and location of urinary stones had no significant relationship with the CT findings.
The characteristics of acute pyelonephritis with urolithiasis differ for each group. A significant correlation was observed between the number of CT findings and the prevalence of sepsis. Predicting the patients’ clinical characteristics and the presence of sepsis will be helpful in treatment.
Key words: Urinary tract infections; Urolithiasis; Multidetector computed tomography
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