Ultrasound Panic Findings in the Urological Region

Abstract

“Panic Findings: Abnormal Findings Requiring Urgent Action” in ultrasonography was published by the Japanese Society of Ultrasound in Medicine. We herein explain the key points of ultrasound panic findings in the urological region. “Urgent findings” in the urological region include fluid retention in the retroperitoneal cavity with internal echogenic spots, caused by renal trauma or rupture of renal tumor, etc. Due to the anatomical characteristics of the kidney being in the retroperitoneum and surrounded by Gerota’s fascia, the mortality rate without immediate treatment is low. By checking ultrasound findings along with vital signs, it is likely that in many cases a urological finding can be treated as a “semi-urgent finding”. There are two “semi-urgent findings” in the urological region. One is dilation of both renal pelvises (calyxes). Extrarenal dilation, where only the renal pelvis is dilated, does not need to be considered a panic finding. If one kidney is non-functioning, dilation of the contralateral renal pelvis and calyx is also a panic finding. The other “semi-urgent finding” is a mass lesion (fluid collection with internal echo) accompanied by fever or tenderness. In renal infection accompanied by fever and tenderness, along with a mass (fluid collection with internal echo), intrarenal emphysema, or renal pelvic distention with debris, is considered a “semi-urgent finding.”