Pre-Hospital and Follow-Up Ultrasound Detection of Hydronephrosis and Perinephric Fluid

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.