POCUS in a patient with flank pain

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Author: Cynthia Kamweru, William Wilson / Editor: Sarah Edwards / Codes: / Published: 01/09/2025

A 34-year-old woman presents to the Emergency Department (ED) with a one-week history of haematuria and three day history of progressively worsening right side flank pain. She describes this pain as 10/10 in severity, colicky in nature and is unable to get comfortable. She has come in today as she started to vomit this morning, and the pain is now unbearable.

Her observations are HR 120, BP 90/72, spO2 – 99% on room air, RR 20, Temp 38.9C

On examination, she is unable to get comfortable on the examination bed, and she is sweating. PA- She is tender in the suprapubic region and over both renal angles. 

Urine dip results- nitrite/leukocyte positive, blood-negative, pregnancy test negative

FBC: WCC 18, CRP 60, Hb 130, eGFR >90, normal LFTs. 

Venous blood gas: pH 7.40, HCO3- 26.0, Lactate 3.6.

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