Beyond the Stone: Diagnostic Value of Non-Contrast Computed Tomography for Renal Colic in the Emergency Department

Aim: Renal colic is a common cause of emergency department (ED) visits, most frequently resulting from urinary tract calculi. Abdominal computed tomography (CT) plays a pivotal role in evaluating patients with suspected renal colic by providing detailed information on the presence, size, and location of stones, as well as the degree of urinary obstruction. This study aimed to assess the diagnostic accuracy and clinical impact of abdominal CT scans ordered in the ED for patients presenting with suspected renal colic.Material and Methods: This retrospective study was conducted in a tertiary care urban ED and included patients diagnosed with renal colic between January 1, 2022, and December 31, 2022. Demographic characteristics, laboratory and imaging findings, CT-based urological findings, additional diagnoses, consultation requirements, ED outcomes, final diagnoses, and the impact of CT results on clinical management were analyzed.Results: Among the included patients, 66.8% were male, with a median age of 42 years. Transabdominal ultrasound was performed in 27.3% of cases, while all patients underwent abdominal CT. Urological findings were observed in 65.5% of cases, including urinary tract calculi (60.1%) and hydronephrosis or pelvicaliectasis (53.7%). CT findings altered urological management in 10.2% of cases and influenced the management approach of other specialties in 2.2%. Most patients (94.9%) were discharged from the ED.Conclusion: Non-contrast abdominal CT is a highly effective diagnostic modality in patients presenting with suspected renal colic, providing accurate detection of urinary stones and contributing to clinical decision-making by identifying both urological and non-urological pathologies.