PREVALENCE AND CLINICAL SIGNIFICANCE OF INCIDENTALLY DETECTED UROLITHIASIS IN PATIENTS UNDERGOING ABDOMINAL-PELVIC CT SCAN

Abstract

Background: Urolithiasis, a globally prevalent condition, is increasingly influenced by modern dietary patterns, dehydration, and environmental changes. While symptomatic stones often lead to medical attention, asymptomatic or incidentally discovered stones are frequently overlooked despite their clinical importance. Detecting such cases is crucial for early management and prevention of future complications. This study aimed to assess the prevalence, demographic trends, and clinical significance of incidentally detected urolithiasis among patients undergoing abdominal-pelvic CT scans in Peshawar, Pakistan.

Objective: To determine the frequency, demographic distribution, and associated risk factors of incidentally detected urolithiasis in patients receiving abdominal-pelvic CT scans.

Methods: A descriptive cross-sectional study was conducted over six months in both public and private hospitals in Peshawar. A total of 163 patients aged 20–60 years who underwent abdominal-pelvic CT scans for various clinical indications were included through convenient sampling. Data on demographics, lifestyle habits, medical history, and radiological findings were collected using a structured form. CT imaging was performed using GE scanners with parameters of 120–140 kVp and 5–10 mm slice thickness. Data were analyzed using SPSS version 26. Frequencies and percentages were calculated for categorical variables, while chi-square tests determined associations between demographic factors and stone characteristics (p < 0.05).

Results: Among 163 patients, 67 (41.1%) had incidentally detected urolithiasis, with a slight male predominance (52.8%). The 20–35-year age group accounted for 52.1% of cases. A positive family history was observed in 62.6% of patients. Key risk factors included low water intake (55.2%), high salt consumption (56.4%), and frequent oxalate-rich food intake (58.9%). Comorbidities included hypertension (20.2%), diabetes (12.9%), and dyslipidemia (14.7%). Radiologically, 46.6% of stones were renal, 41.1% ureteral, and 12.3% vesical, with 53.4% measuring 4–10 mm.

Conclusion: The study revealed a high rate of incidental urolithiasis, emphasizing the need for early detection and preventive strategies. Encouraging adequate hydration, dietary moderation, and control of metabolic risk factors can significantly reduce recurrence and disease burden. Although CT remains the gold standard for diagnosis, its judicious use is vital in low-resource settings to balance accuracy, cost, and radiation exposure.