Renal Colic

Diagnostic Points:
  • The patient is in a state of agony.  He moves in the bed constantly to find relief in any posture, whereas in acute appendicitis, patient lies motionless due to localized pain.
  • Pain starts from the lumbar area and goes down towards the groin and inner side of thigh.  Intensity of pain may vary but patient is never free of pain during an episode of renal colic.
  • Urinary symptom i.e. burning micturition, haematuria, increased frequency or anuria, rigors.
  • Presence of fever with or without rigors indicates pyelonephritis.
  • There may be nausea and vomiting.
  • On examination of abdomen, tenderness at renal angle and lumbar area will be elicited.
Investigations:
  • Blood Complete Examination:  Leukocytosis (mainly neutrophils).
  • Urine Complete Examination:  Look for deposits, casts and RBCs.Plain X-Ray Abdomen:  Stone may be seen.
  • Ultrasound Examination KUB may show renal stone, hydronephrosis etc.
  • IVP later on may show hydronephrosis, stone, etc.
Management:
  • Injection of NSAIDS e.g. diclofenac sodium.
  • If pain is not relieved then Inj. Nalbufin 10 mg I/V.
  • Patient is kept nil by mouth (NPO) in uncontrolled cases with nausea and vomiting, and he is given I/V fluids.
  • Urinary antiseptics i.e. ciprofloxacin or ofloxacin are given to treat associated infection.