Renal Colic

• Renal colic is generally used to describe acute and severe loin pain
caused by renal stones obstructing urinary flow.
The most common cause of renal colic :
• is stones , blood clots (from uppertract bleeding) or sloughed renal
papillae(which can occur in patients with diabetes,sickle cell disease
or long-term analgesia use)must also be considered

Approximately 5% to 15% of the population will be affected by a kidney

stone, and of those, 50% will have a recurrent stone within five to
seven years of the initial presentation if preventive measures are not
taken. Over 70% of stones occur in people 20 to 50 years old
The classical presentation of renal colic :
• acute, intermittent flank pain radiating to the groin or scrotum.
As the stone descends the ureter, pain may localize to the abdomen
overlying the stone.

Signs of sepsis :
fever, tachycardia and hypotension, may indicate an obstructing stone
with infection, necessitating urgent urology referral.
Diagnosis is made through a combination of history and physical
exam, laboratory testing, and imaging studies.
• Urinalysis shows some degree of microscopic or gross hematuria
in 85% of stone patients, but should also be evaluated for signs of
infection
• Hematuria is present in 85% of acute renal colic cases caused by
calculi.
• Urinary pH
• greater than 7.5 may be suggestive of a urease producing bacterial
infection,
• less than 5.5 may indicate the presence of uric acid calculi.
Abdominal X-ray in a patient with renal colic with
very severe pain from the lumbar region to the genitals
X-ray of the pelvis, showing
renal colic caused by
urolithiasis in the left ureter.
Differential diagnosis
• Aortic aneurysms
• Biliary colic
• Iliac aneurysms
• Endometriosis
• Ovarian torsion
• Peritonitis
• Pyelonephritis
• Renal cancer
 The management of acute renal colic

Symptom management :
• ondansetron or metoclopramide for relief of nausea or vomiting
• Non-steroidal anti-inflammatory drugs should be used as the first line
in all except those with a specific contraindication
• recommends the use of diclofenac (oral, perrectal or intramuscular
preparations)
The management of acute renal colic
Complications of Urolithiasis :

• Renal failure
• Ureteral stricture
• Infection, sepsis
• Urine extravasation
• Perinephric abscess
• Xanthogranulomatous pyelonephritis
• Laryssa Patti; Stephen W. Leslie.2021. Acute Renal Colic. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK431091/
• ANDREW J. PORTIS, M.D., and CHANDRU P. SUNDARAM, M.D.
Diagnosis and Initial Management of Kidney Stones. Retrieved from
https://www.aafp.org/afp/2001/0401/p1329.html