Acute severe pain in the loin (kidney area) as a result of obstruction of the ureters by a stone.
Causes
- Urinary stones
- Rarely clot or tumor
Clinical features
- Acute, severe, colicky loin pain often radiating to the iliac fossa, testes, or labia of the same side
- At times dysuria
- Nausea and vomiting
Differential diagnosis
- Lower UTI
- Acute upper UTI
- Other causes of acute abdominal pain
Investigations
- Urinalysis (for blood)
- Plain abdominal X-ray: for radio-opaque stones
- Ultrasound
Management
- Oral or IV fluids to mantain hydration
- Antiemetics if necessary e.g. metoclopramide 10 mg IM or IV
- Diclofenac 75 mg IM single dose
and/or - Pethidine 50-100 mg IM single dose
Refer if repeated episodes/unresolving episode.
Prevention
- Ensure oral fluid intake of 3-4 L/day
- Reduce salt intake and animal protein