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Having flank pain. CT shows no urolithiasis or obstructive uropathy. Is CT always accurate ?

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Practicing since : 2005
Answered : 34 Questions

This was the readings from the other day.


Clinical history: Left flank pain

Axial scans the abdomen and pelvis were obtained in helical CT
scanner utilizing the urinary tract stone protocol. 5 mm
contiguous scan images were obtained beginning above the level of
the hemidiaphragms and continuing inferiorly below the symphysis
pubis. From source data, coronal reformations were also obtained.
No oral or intravenous contrast was utilized.

There is no CT evidence of urolithiasis or obstructive uropathy.
No discrete renal cortical abnormalities are noted in this
unenhanced examination.

No acute appearing bowel related abnormalities are noted. The
appendix is retrocecal and extends cephalad along the medial
aspect of the ascending colon. There is a radiopaque density in
the small bowel lumen on the right side of the abdomen presumably
radiopaque medication or other ingested material.

Liver, spleen, and pancreas are are normal appearing. No biliary
obstructive findings are present; the gallbladder is normal

No mesenteric or pericolic soft tissue abnormalities are
appreciated. No free fluid is seen in the abdomen or pelvis.

Wet read report submitted through the PACs system at 1312 hours.

1. No urolithiasis or obstructive uropathy.
2. No intra-abdominal, retroperitoneal, or pelvic mass
abnormality or abnormal fluid collection.
3. No acute appearing bowel related abnormality.

My question is, because I guess I am worrysome. I was told that they view these scans on large high definition screens and can catch anything that is not right.
I am just worried that they could have missed a mass or something on the liver, gallbladder, pancreas or kidneys. How possible is that.

Am I worrying for nothing?

I hear that I am too young for some of those cancers and the blood work would have required further testing.

Posted Tue, 22 May 2012 in Urinary and Bladder Problems
Answered by Dr. Ranjeet Jagdale 2 hours later

Thank you for posting your query.

Considering your age and symptoms, it is highly unlikely that you have a lesion that has gone undiagnosed and although plain scan could miss certain lesions, it is not probable that anything significant has been missed.

From my perspective, I think you should not be worried about this, and if you have done your scan at a well established centre, their radiology staff should be competent and would not have missed anything significant.

And yes it is true that CT scans are read on a high resolution monitor so again decreasing the possibility of missing any significant lesion.

I hope I have succeeded in reassuring you, as in my opinion, there is really nothing for you to be worried about.

I hope this helps you. Please feel free to write back if you have any additional concerns.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Having flank pain. CT shows no urolithiasis or obstructive uropathy. Is CT always accurate ? 1 hour later
This was my situation.

I am writing for advice. I went to my Family Practice doctor on Monday of this week, several days ago early in the morning around 9 AM. I explained to her about the stomach pains I was having and she ordered an abdominal ultrasound for this coming up Friday which is tommorw. After leaving her office on Monday around 2PM I started having bad bad pains in the stomach so I went to the ER, where they performed blood work, uranalysis and the CT which the results are above. Since I had that done on Monday and got the results of that CT is there any need to still go get the abdominal ultrasound? I have not told the doc I went to the ER because she hasnt been in the office. Are the pictures more defined in a CT and considered a far more in depth scan than an ultrasound I would assume this test would suffice? I would assume there is no need for an ultrasound at this point, would you agree?
Answered by Dr. Ranjeet Jagdale 1 hour later
Hello again,

Thank you for writing back.

It would be great if you could clarify regarding your abdominal pains,

1. Are you still getting these pains?

2. If yes, where exactly? (you can describe the location in relation to the naval).

If you had pain only on Monday and did not have a repeat episode then according to me you need not worry and no there is need to get an Ultrasound done, however if you are still having the severe pain then go ahead and get USG.

Hope this helps you. Please accept the answer if you have no further questions.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Having flank pain. CT shows no urolithiasis or obstructive uropathy. Is CT always accurate ? 3 hours later
Just posted new results for my ct scan. Check them out. The pains i have sometime are about 6 inches above the belly button. It could be acid reflux since the major stuff is ruled out.
Answered by Dr. Ranjeet Jagdale 5 hours later
Thanks for writing back.
I have gone through your reports and the acid reflux disease seems to be the cause of your pain. Further, you no longer need an ultrasonography (USG) and your CT scan is good enough.
Please speak with your physician about the need for an upper gastrointestinal endoscopy. Meanwhile, I would suggest the following:
a. Steer clear of cigarettes and alcohol
b. Have small, frequent meals throughout the day
c. Have an early dinner
d. Avoid spicy and oily foods
e. You can also take tablet Prevacid OTC once a day 1 hour before meals.
This will help reduce the pain to a great extent

I hope I have addressed your concerns. Please close this discussion if you have no more questions.


Above answer was peer-reviewed by
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