RENAL COLIC

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