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Ultrassonografia de hidronefrose e líquido perinéfrico no pré-hospitalar e seguimento clínico
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Abstract(s)
A ultrassonografia de triagem é essencial nos serviços de emergência, proporcionando uma ferramenta rápida e precisa para detetar patologias associadas à cólica renal, como hidronefrose ou obstrução urinária. Sua portabilidade, capacidade de gerar imagens em tempo real e a ausência de radiação, tornam ideal para ambientes com recursos limitados, como serviços básicos de urgência periféricos em Portugal, onde o caso descrito ocorreu.
O uso da ultrassonografia de triagem por profissionais treinados através de ensino teórico e prático universitário permite uma resposta imediata a questões clínicas em contextos de emergência. Este artigo enfatiza a importância da ultrassonografia na avaliação inicial de pacientes com cólica renal e suspeita de hidronefrose e ou obstrução urinária, auxiliando nas decisões sobre tratamento e encaminhamento às especialidades.
Neste estudo, um paciente foi admitido em um serviço básico de emergência periférico com sintomas de cólica renal. A ultrassonografia inicial revelou dilatação pielocalicial discreta e líquido perirrenal, com permeabilidade bilateral dos jatos urinários mantida. Com base nesses resultados, iniciou-se tratamento conservador com medicação analgésica. À medida que o paciente melhorava, foi decidido continuar o acompanhamento com ultrassonografia ambulatória. No terceiro dia, o líquido perirrenal já não era visível e o grau de dilatação pielocalicial diminuiu. No sétimo dia, não havia sinais de dilatação pielocalicial ou líquido perirrenal, e o paciente manteve-se assintomático.
A ultrassonografia de triagem contribui para a segurança do paciente, permitindo a deteção precoce de patologias urinárias e reduzindo a sobrecarga dos hospitais centrais ao direcionar casos mais simples para acompanhamento ambulatório supervisionado ecográfica e clinicamente.
Abstract: Screening ultrasound is essential in emergency services, providing a fast and accurate tool for detecting pathologies associated with renal colic like hydronephrosis or urinary obstruction. Its portability, real-time imaging, and lack of radiation make it ideal for environments with limited resources, such as peripheral basic emergency services in Portugal, where the described case occurred. The use of screening ultrasound by trained professionals based on theoretical and practical teaching enables an immediate response to clinical questions in emergency contexts. This article emphasizes the importance of ultrasound in the initial assessment of patients with renal colic and suspected hydronephrosis/urinary obstruction, aiding decisions regarding treatment and referral to specialists. In this study, a patient was admitted to a basic peripheral emergency service with symptoms of renal colic. The initial ultrasound revealed discrete hydronephrosis and perirenal fluid, with bilateral patency of the urinary jets. Based on these results, conservative treatment with pain relief medication was initiated. As the patient improved, the physician decided to continue monitoring the patient with follow-up ultrasounds on an outpatient basis here, imaging improvements were observed. By the third day, perirenal fluid was no longer visible, the degree of pelvicalyceal dilation had decreased, and the patient was asymptomatic. By the seventh day, there were no signs of pelvicalyceal dilation or perirenal fluid, and the patient remained asymptomatic. Screening ultrasound contributes to patient safety by enabling early detection of urinary pathologies and reducing the burden on central hospitals by redirecting simpler cases that can be managed on an outpatient basis with appropriate follow-up, thereby avoiding risks to the patients.
Abstract: Screening ultrasound is essential in emergency services, providing a fast and accurate tool for detecting pathologies associated with renal colic like hydronephrosis or urinary obstruction. Its portability, real-time imaging, and lack of radiation make it ideal for environments with limited resources, such as peripheral basic emergency services in Portugal, where the described case occurred. The use of screening ultrasound by trained professionals based on theoretical and practical teaching enables an immediate response to clinical questions in emergency contexts. This article emphasizes the importance of ultrasound in the initial assessment of patients with renal colic and suspected hydronephrosis/urinary obstruction, aiding decisions regarding treatment and referral to specialists. In this study, a patient was admitted to a basic peripheral emergency service with symptoms of renal colic. The initial ultrasound revealed discrete hydronephrosis and perirenal fluid, with bilateral patency of the urinary jets. Based on these results, conservative treatment with pain relief medication was initiated. As the patient improved, the physician decided to continue monitoring the patient with follow-up ultrasounds on an outpatient basis here, imaging improvements were observed. By the third day, perirenal fluid was no longer visible, the degree of pelvicalyceal dilation had decreased, and the patient was asymptomatic. By the seventh day, there were no signs of pelvicalyceal dilation or perirenal fluid, and the patient remained asymptomatic. Screening ultrasound contributes to patient safety by enabling early detection of urinary pathologies and reducing the burden on central hospitals by redirecting simpler cases that can be managed on an outpatient basis with appropriate follow-up, thereby avoiding risks to the patients.
Description
Keywords
Hidronefrose Patência Perinefrítico Triagem Ultrassom Hydronephrosis Outpatient Pyelocaliceal Perinephric Screening Ultrasound
Citation
MIRAVENT, Sérgio [et al.] (2025) - Ultrassonografia de hidronefrose e líquido perinéfrico no pré-hospitalar e seguimento clínico. ROENTGEN. Vol. 6, n.º 1, p. 10-16.
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