PURPOSE: The aim of this research was to evaluate the diagnostic yield of urgent CT KUBs and assess the appropriateness of their use in the investigation of acute renal colic at King Fahad specialist hospital , Buraydah, Saudi Arabia 2022.
METHODS: All data were collected retrospectively from patient’s records including all patients who presented to the emergency and inpatients undergo unenhanced CT KUB to rule out urinary tract stones . Follow-up requests of known urolithiasis and any scan done for other clinical indications were excluded ,representing 3.7% .
RESULTS:
This study reviewed 1671 patients, 24.9% were aged between 31 and 40 years old, with nearly 60% being males. Most patients were admitted to ER (98%) and referred by non-urology physicians (99%). The prevalence of patients who were diagnosed with renal stones was 38.7%. Among patients who were presented with acute renal colic and CT scan revealed no urolithiasis, there was 11% with incidental and other alternative diagnosis. The most common finding was genitourinary diseases (48.9%), followed by gastrointestinal diseases (27.2%).
CONCLUSION:
The significant percentage of negative CT KUB of the examined patients reflects the physicians misapplication with this technique with a subsequent reduction in the rate of renal calculi detection with unnecessary radiation exposure as well as increased the alternative/incidental of extraordinary findings, which may indicate further emergency abdominal CT studies. Therefore, urology opinion before CT-KUB requested for patients with atypical presentation is highly advised. Additionally , departmental ultrasound is suggested mainly for the young females prior to CT scan to rule out any gynecological conditions that can mimic renal stones.
License
This work is licensed under a Creative Commons Attribution 4.0 International license
References
- Patti L, Leslie SW, Leslie W. Acute Renal Colic, Treasure Island (FL); 2023. StatPearls Publishing.
- Kamal1 W, Azhar2 RA, Hamri3 SB. The Saudi urological association guidelines on urolithiasis. Urology Annals. 2024;16(1):1–27. Jan–Mar. doi:10.4103/ua.ua12023.
- Yilmaz S, Sindel T, Arslan G, Özkaynak C, Karaali K, Kabaalioğlu A et al. Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi. Eur Radiol. 1998;8(2):212–7.
- Mehwash Nadeem a, M Hammad Ather a, Anila Jamshaid a, Samrah Zaigham b, Rabeea Mirza b, Basit Salam c Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic. International Journal of Surgery. 2012;.
- Grey S, O’Leary D. A. Ramlaul; Hatfield/UK ,The role of unenhanced Computed Tomography of Kidney, Ureter and Bladder (UHCT-KUB) in diagnosing suspected acute renal colic within an NHS hospital. European Congress of Radiology - Pub- lished. 2016;.
- Smith RC, Rosenfield AT, Choe KA, Essenmacher KR, Verga M, Glickman MG et al. Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urogra- phy. Radiology. 1995;194(3):789–94.
- Ghazwani Y. 1,2,3 Rakan Aldarrab,1 Mohammad A Alghafees,Trends of Acute Renal Colic During COVID-19 Lockdown: An Experience From Saudi Arabia , Cureus. 2022;14(9):e29481.
- Smith1 C, Narula L, Arnfield E. QLD/AU, 2Townsville/AU, Evaluating the diagnostic yield of CT KUB at a tertiary institution. 2017;ASM / R-0089.
- Amin KMBM, Graham J. Wellington/NZ, 2Palmerston North/NZ , The use of CT KUB in evaluation of suspected renal colic in emergency department: a secondary care hospital experience. 2019;ASM.

