Optimization of Diagnostics of Urolithiasis in Children in Emergency Surgical Care

Introduction. Obstruction of the urinary tract by a calculus causes renal dysfunction, increases the risk of renal failure, and requires its emergency relief. The main clinical signs that allow us to suspect the possibility of renal colic include pain in the lumbar region, nausea, vomiting, and macro- or microhematuria. However, history and physical examination alone are imperfect in diagnosing renal colic, and additional methods of pathology imaging are needed. The purpose of this work is to present the experience of diagnosis and treatment of children with renal colic as a manifestation of urolithiasis in the conditions of emergency surgical care at the Children’s City Clinical Hospital No. 9. Materials and methods. In the Surgical Department No. 3 from 2011 to 2024, 486 children aged 1 to 18 years with clinical presentation of renal colic against the background of urolithiasis were treated on an emergency basis. The children underwent emergency laboratory diagnostics, sonography, and since 2021, CT urography, which allowed dividing all the material into 2 groups (before and after the introduction of CT diagnostics with bolus contrast): I — n = 194; II — n = 292. Results and discussion. In half of the cases, emergency surgical treatment was provided. In group I (2011–2020) 35/194 (18 %) children required surgical treatment to relieve renal obstruction. In the group II (2021–2024) 217/292 (74 %) patients received surgical care. Conclusions. The emergency hospitalization of children with renal colic has increased since 2021 after the change in the diagnostic protocol for children with urolithiasis. The introduction of CT with bolus contrast and its emergency use has improved the diagnosis of the cause of renal colic in children. The significant effectiveness of CT in urolithiasis has been proven, which has improved not only diagnostics, but also influenced the tactics of emergency admission of patients with renal colic.