Acute Management of Renal Colic and Compliance with National Standards: Closure of the Audit Loop

• Main Author: Goonewardene SS P Rajjayabun (Author)
• Format: Book
• Published: Archives of Renal Diseases and Management - Peertechz Publications, 2016-02-01.
• Subjects: Research Article
• Online Access: Connect to this object online.

<p>Renal (ureteric) colic is a common surgical emergency. It is usually caused by calculi obstructing the ureter, but about 15% of patients have other causes, e.g. extrinsic compression, intramural neoplasia or an anatomical abnormality [1]. Up to 12 percent of the population will have a urinary stone during their lifetime, and recurrence rates approach 50 percent [2]. Fifty-five percent of those with recurrent stones have a family history of urolithiasis [3] and having such a history increases the risk of stones by a factor of three [4]. Upon presentation to the A&E department, suspected acute renal colic patients must have a clinical examination and radiological investigations to confirm the diagnosis [5]. <br></p><p>The best imaging study to confirm the diagnosis of a urinary stone in a patient with acute flank pain is unenhanced, helical CT of the abdomen and pelvis [6]. If CT is unavailable, plain abdominal radiography should be performed, since 75 to 90 percent of urinary calculi are radiopaque [5]. Although ultrasonography has high specificity (greater than90 percent), its sensitivity is much lower than that of CT, typically in the range of 11 to24 percent [5]. Thus, ultrasonography is not used routinely but is appropriate as the initial imaging test when colic occurs during pregnancy [7]. </p>