Renal Colic

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CLINICAL DESCRIPTION

The syndrome caused by stone(s) passage down the urinary tract. Typically affecting males aged 20 – 40. Colicky abdominal pain (often very severe), radiating from loin to groin (especially as stones moves toward the vesico-ureteric junction.

CLINICAL FEATURES

SIGNS AND SYMPTOMS

  • Nausea and vomiting are common. Renal angle tenderness, hematuria (often macroscopic), dysuria and symptoms of UTI.

INVESTIGATIONS

  • Full blood count
  • Urea, creatinine and electrolytes including calcium
  • Serum Uric acid
  • Urine dipstick and microscopy
  • Abdominal erect xray
  • KUB Ultrasound

TREATMENT

  • Intravenous fluids
  • Give Morphine or Pethidine.
  • Give Hyoscine butylbromide 20 mg deep IM stat
  • Consider Sodium bicarbonate 1 sachet 24 hourly
  • Repeat after 30 minutes if necessary
  • Ensure fluid intake of 3-4 litres/day after the crisis
  • Intravenous Pyelography is usually indicated