Renal Colic

Overview

Predisposing factors

Diagnosis

Management

Avoid high volume IV fluids acutely (does not accelerate passage of stone and may increase pain or cause urinary extravasation)

Buscopan of little benefit

Laboratory Investigations

Imaging

First presentation

At centres with CT :

At centres without CT :

AND

Subsequent presentation:

KUB only

  Advantages Disadvantages
KUB Easily available
Low radiation dose
Limited sensitivity for calculi
Does not identify obstruction
IVP Highly sensitive for calculi
Identify alternative pathology
Determines obstruction
Identifies solitary kidney
Contrast load
Not always available
High radiation dose
Helical CT Highly sensitive for calculi
Diagnoses alternative pathology
Determines obstruction
Identifies solitary kidney
Expensive
Not always available
High radiation dose
Ultrasound Identifies alternative pathology
Identifies obstruction
Identifies solitary kidney
Limited sensitivity for calculi
Not always available

Disposition

Criteria for admission:

Discharge instructions

see GP handout 

see Kidney stones handout

see Clean catch specimen

Urology outpatient clinic if:

Prevention

References

Dunn R et al (2000) " Urinary Stone Disease" in The Emergency Medicine Manual 2nd Ed. pub Venom Publishing, Adelaide, SA