Case 2 - AKI - Urosepsis
Indication:
The patient presented with a constellation consistent with urosepsis secondary to left pyelonephritis. As such nephrolithiasis would be a possible etiology. Hence, PoCUS was deployed to look for hydronephrosis to infer the presence of obstruction.
If there was hydronephrosis, CT will be obtained to look for the obstruction. If it was present, it may alter management -- ureteric stenting/nephrostomy tube.
Image Acquisition:
Both kidneys were imaged to look for hydronephrosis.
The patient presented with a constellation consistent with urosepsis secondary to left pyelonephritis. As such nephrolithiasis would be a possible etiology. Hence, PoCUS was deployed to look for hydronephrosis to infer the presence of obstruction.
If there was hydronephrosis, CT will be obtained to look for the obstruction. If it was present, it may alter management -- ureteric stenting/nephrostomy tube.
Image Acquisition:
Both kidneys were imaged to look for hydronephrosis.
Interpretation:
Hydronephrosis was present in the left kidney.
Clinical Synthesis:
CT was ordered which revealed a stone at the left UPJ. Urology was consulted, and a nephrostomy tube was placed.
This utility of PoCUS, again, was the speed to diagnosis and time-to-decision. (This all occurred on the day of presentation.) In addition, source control was obtained rapidly to alleviate the urosepsis.
Hydronephrosis was present in the left kidney.
Clinical Synthesis:
CT was ordered which revealed a stone at the left UPJ. Urology was consulted, and a nephrostomy tube was placed.
This utility of PoCUS, again, was the speed to diagnosis and time-to-decision. (This all occurred on the day of presentation.) In addition, source control was obtained rapidly to alleviate the urosepsis.