Authors: Andrew Parfitt, Shwetha Rao / Editors: Jason M Kendall / Reviewer: Sarah Hickin-Yacoub, Shwetha Rao / Code: A3, O5 / Published: 05/10/2021
Description:
This session looks at the classic presentations of renal colic and its management in the emergency department (ED). It focuses on the investigation techniques and their strengths and weaknesses. Its also looks at the complications that need urgent urological intervention.
After completing this session you will be able to:
- Identify the condition of renal colic and its classic presentations and variations
- List the differential diagnosis, i.e. red flag histories that often masquerade as renal colic
- Identify cases that require emergency intervention or hospitalisation
- Identify when it is safe to discharge a patient
- Identify the appropriate blood and urine tests and state their limitations
- Interpret CT KUB, ultrasound and IVU images when identifying stone disease, and state the advantages and drawbacks of each method
References:
- Parmar MS. Kidney stones. BMJ. 2004 Jun 12;328(7453):1420-4.
- Portis AJ, Sundaram CP. Diagnosis and Initial Management of Kidney Stones. American Family Physician. Apr 1;63(7):1329-38.
- Chandhoke PS. Evaluation of the Recurrent Stone Former. Urological Clinics North America. 2007 Aug;34(3):315-22.
- Jindal G, Ramchandani P. Acute Flank Pain Secondary to Urolithiasis: Radiologic Evaluation and Alternate Diagnoses. Radiological Clinics North America. 2007 May;45(3):395-410.
- Holdgate A, Pollock T. Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Versus Opioids for Acute Renal Colic. Cochrane Database Systematic Reviews. 2005 Apr 18;(2):CD004137.
- Nabi G et al. Extra-corporeal Shock Wave Lithotripsy (ESWL) Versus Ureteroscopic Management for Ureteric Calculi. Cochrane Database Systematic Reviews. 2007 Jan 24;(1):CD006029.
- Pais VM Jr et al. Urolithiasis in Pregnancy. Urological Clinics North America. 2007 Feb;34(1):43-52.
- Resim S, Ekerbicer H, Ciftci A. Effect of tamsulosin on the number and intensity of ureteral colic in patients with lower ureteral calculus. Int J Urol. 2005 Jul;12(7):615-20.
- Singh A et al. A Systematic Review of Medical Therapy to Facilitate Passage of Ureteral Calculi. Annals Emergency Medicine. 2007 Nov;50(5):552-63.
- National Institute for Health and Care Excellence,
Renal and ureteric stones: assessment and management [NG118]. 2019. [Accessed 21 Feb 2020]. - Miller OF, Kane CJ. Time to stone passage for observed ureteral calculi: a guide for patient education. J Urol 1999 Sep;162(3 Pt 1):688-90;discussion 690-1.
- Campschroer T, Zhu X, et al. Alphablockers as medical expulsive therapy for ureteral stones. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD008509.
- Trk C, Knoll T, Petrik A, et al. Guidelines on urolithiasis; Arnhem; European Association of Urology 2014. [accessed 21 Feb 2020].