Authors (including presenting author) :
Lam CM(1), Chan KW(1) , Lo W(1), Cheung KL (1), Cheung WW (1), Chow SY(1), Kwok YN(1), Kwok YL(1), Lai PY(1), Lee WY(1), Ng CL(1), Ng KF(1), Ng PH(1), Tam HS(1), Wong MH(1), Wong YS(1), Yiu MP (1)
Affiliation :
(1)Department of Family Medicine and Primary Health Care, West Kowloon Cluster
Introduction :
Urological and hepatobiliary problems are very commonly encountered in primary care. Appropriate use of bedside Point of Care Ultrasonography (POCUS) by trained Family Physician can give more comprehensive workup for these problems. This allows timely diagnosis, despite of the long waiting time of imaging investigation and specialist outpatient clinic in public sector.
Objectives :
To work up on the underlying causes of urological and hepatobiliary problems using POCUS in Family Medicine clinic.
Methodology :
Suitable cases of epigastric pain, loin pain, deranged liver function, deranged renal function or lower urinary tract symptoms (LUTS) encountered in the Department of Family Medicine and Primary Health Care of Kowloon West Cluster were recruited to receive POCUS performed by Family Medicine specialists who had received relevant training.
Result & Outcome :
In 2024, 2305 cases of POCUS of hepatobiliary or urinary system were performed. 1767 pathologies were detected. Some common pathologies included benign prostatic hyperplasia (530), fatty liver (309), renal stone (140), gallstone (127), renal parenchymal disease (109), and gallbladder polyp (83). Some less common but important pathologies detected were hydronephrosis (44) renal tumor (2),bladder polyp and tumor (2) and prostatic cancer (1). 85 cases required either surgical or non-surgical intervention after POCUS.
One of the important findings in our statistics is that a significant number of hydronephrosis was detected. Although in majority of cases of hydronephrosis, urinary stone is the cause of obstruction, there are still other non-calculus lesions which can lead to hydronephrosis but cannot be shown on X-ray. In our POCUS experience, we detected these non-calculus lesions at different levels of the urinary system, including pelvi-ureteric junction, ureter, vesico-ureteric junction and prostatic urethra. Since hydronephrosis is potentially reversible, early detection allows management at an early stage for these more hidden and potentially serious conditions. Our study demonstrates that with proper training, POCUS can be well utilized in Family Medicine to improve patient outcome.
