Sasbel 2

Patofisiologi nyeri pinggang

 FLANK PAIN
• Non-renal etilogies
• Renal etiologies
– Parenchymal
– Non-parenchymal
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Non-Renal Etiologies
Inflammation or nerve irritation. Common causes:
• Musculoskeletal strain
• Musculoskeletal contusion
• Dermatologic conditions
• Neurologic conditions
• Compression from local growth of a mass
• Referred pain from thoracic pathologies
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Renal Parenchymal Etiologies
Involving the renal parenchyma. Inflammation,
infarction, stretching
• Pyelonephritis
• Renal abscess
• Renal infarction
• Venous obstruction
• Renal tumor
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Non-Parenchymal Renal Etiologies
Mostly involves obstruction.
• Nephrolithiasis
• Stricture disease
• Extrinsic compression
• Bladder outlet obstruction
• Intraluminal obstruction
 Nephrolithiasis
• Dilation
• Stretching
• Spasm
As the ureter proximal to the stone distends,
some urine can sometimes flow around the
obstruction, relieving the proximal hydrostatic
pressure and establishing a stable, relatively
painless equilibrium. These factors explain why
severe renal colic pain typically lasts less than 24
hours in the absence of any infection or stone
movement.

Nephrolithiasis
Author: Chirag Dave, MD; Chief Editor: Bradley Fields Schwartz
http://emedicine.medscape.com/article/437096-overview#a4
• A stone moving down the ureter and causing only intermittent
obstruction actually may be more painful than a stone that is
motionless