renal colic; renal pain; ureteral spasm
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Introduction
Also see urinary calculus (nephrolithiasis)
Etiology
- impaction or passage of a stone in the ureter or renal pelvis
Clinical manifestations
- severe spasmodic abdominal pain
- pain may be constant
- often radiates to the groin
- cessation of ureteral colic associated with passage of stone in 75% of cases; ureteral stone(s) persist in 25% of cases[7]
Radiology
- ultrasound initial diagnostic test[4]
- CT urography provides more detail at higher dost & radiation exposure
Management
- analgesics:
- prognosis
- only 1 in 8 patients presenting to emergency department with renal colic undergo urologic procedure within 2 months[8]
- only 1 in 20 patients presenting to emergency department with renal colic return to emergency department within 1 week[8]
- for stones < 9 mm, at 1 month
- 20% of patients had persisting ureteral stones
- ~1/2 of the 20% had neither hydronephrosis nor pain[9]
- 20% of patients had persisting ureteral stones
More general terms
Additional terms
References
- ↑ Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999
- ↑ Jump up to: 2.0 2.1 Journal Watch 24(16):125, 2004 Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. BMJ. 2004 Jun 12;328(7453):1401. Epub 2004 Jun 03. Review. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15178585 <Internet> http://bmj.bmjjournals.com/cgi/content/full/328/7453/1401
- ↑ Jump up to: 3.0 3.1 Safdar B, Degutis LC, Landry K, Vedere SR, Moscovitz HC, D'Onofrio G. Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic. Ann Emerg Med. 2006 Aug;48(2):173-81, 181.e1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16953530
- ↑ Jump up to: 4.0 4.1 Smith-Bindman R et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med 2014 Sep 18; 371:1100. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25229916 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1404446
- ↑ Bultitude M, Rees J. Management of renal colic. BMJ 2012;345:e5499 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22932919
- ↑ Jump up to: 6.0 6.1 Pathan SA et al. Delivering safe and effective analgesia for management of renal colic in the emergency department: A double-blind, multigroup, randomised controlled trial. Lancet 2016 Mar 15; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26993881 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2900652-8/abstract
- ↑ Jump up to: 7.0 7.1 Hernandez N et al. Cessation of ureteral colic does not necessarily mean that a ureteral stone has been expelled. J Urol 2018 Apr; 199:1011. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29107030 <Internet> http://www.jurology.com/article/S0022-5347(17)77794-4/fulltext
- ↑ Jump up to: 8.0 8.1 8.2 Schoenfeld EM, Shieh MS, Pekow PS et al. Association of patient and visit characteristics with rate and timing of urologic procedures for patients discharged from the emergency department with renal colic. JAMA Netw Open 2019 Dec 2; 2:e1916454 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31790565 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2756110
- ↑ Jump up to: 9.0 9.1 Jackman SV et al. Resolution of hydronephrosis and pain to predict stone passage for patients with acute renal colic. Urology 2022 Jan; 159:48. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34627871 Clinical Trial. https://www.goldjournal.net/article/S0090-4295(21)00904-3/fulltext