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Pediatr Emerg Care 2016 Aug;32(8):544-8

Assistant Professor of Pediatrics and Director of Emergency Ultrasound (Steimle), Assistant Professor of Pediatrics (Plumb), Professor of Pediatrics (Corneli), Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.

Anuria in children may arise from a host of causes and is a frequent concern in the emergency department. This review focuses on differentiating common causes of obstructive and nonobstructive anuria and the role of point-of-care ultrasound in this evaluation. We discuss some indications and basic techniques for bedside ultrasound imaging of the urinary system. Read More

Am J Emerg Med 2011 Sep 8;29(7):843.e1-3. Epub 2010 Oct 8.

Department of Emergency Medicine, Alameda County Medical Center, Highland Hospital, Oakland, CA 94602, USA.

Identifying acute pyelonephritis (APN) with early obstructive uropathy is clinically important in the emergency department (ED) because obstructive urolithiasis is an independent risk factor for inpatient death, prolonged hospitalization, and failure of outpatient APN therapy. Furthermore, diagnosis of an early obstructive uropathy can be difficult when based solely on clinical findings. Clinicians may assume the cause of the patient's symptoms to be APN alone, without considering the concurrent presence of an obstructing stone. Read More

Acad Emerg Med 2010 Sep;17(9):1024-7

Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Olive View Medical Center, Sylmar, CA, USA.

Background: Given the time, expense, and radiation exposure associated with computed tomography (CT), ultrasonography (US) is considered an alternative imaging study that could expedite patient care in patients with suspected obstructive uropathy. However, there is a paucity of literature regarding bedside US for obstructive uropathy in the emergency department (ED), and it is unknown how much experience is required for competency in such exams.

Objectives: The objective was to assess the learning curve for the detection of obstructive uropathy of resident physicians training in ED bedside US (EUS) during a dedicated EUS elective. Read More

J Emerg Med 2004 Oct;27(3):265-9

Division of Critical Care & Emergency Services, LeBonheur Children's Medical Center, Memphis, Tennessee, USA.

We present a case of shock in a 7-week-old neonate with obstructive uropathy secondary to posterior urethral valves (PUV). The antenatal ultrasound and the 2-week maintenance visit were unremarkable. A screening emergency physician directed bedside ultrasound (SEPUS) served to rapidly establish the diagnosis, initiate appropriate management, and facilitate early relief of urinary obstruction. Read More