Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Trauma: adult trauma
- Trauma: paediatric trauma
- Trauma: trauma scoring systems
- Trauma: traumatic brain injury
- Trauma: thoracic trauma
- Trauma: abdominal trauma
- Burns
- Acute abdomen
- Acute pancreatitis
- Acute appendicitis
- Acute cholecystitis
- Large-bowel obstruction
- Small-bowel obstruction
- Perforated gastro-duodenal ulcer
- Volvulus
- Gastrointestinal bleeding
- Mesenteric ischaemia
- Acute limb ischaemia
- Leaking abdominal aortic aneurysm
- Epistaxis
- Inhaled foreign body (FB)
- Urinary retention
- Gross haematuria
- Renal colic
- Testicular pain
- Priapism
- Paraphimosis
- Necrotizing fasciitis
- Principles of fracture classfication and management
- Compartment syndrome
- Acute abdominal pain in pregnancy
- Paediatric surgical emergencies
- Acute hand injuries
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Renal colic
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Trauma: adult trauma
- Trauma: paediatric trauma
- Trauma: trauma scoring systems
- Trauma: traumatic brain injury
- Trauma: thoracic trauma
- Trauma: abdominal trauma
- Burns
- Acute abdomen
- Acute pancreatitis
- Acute appendicitis
- Acute cholecystitis
- Large-bowel obstruction
- Small-bowel obstruction
- Perforated gastro-duodenal ulcer
- Volvulus
- Gastrointestinal bleeding
- Mesenteric ischaemia
- Acute limb ischaemia
- Leaking abdominal aortic aneurysm
- Epistaxis
- Inhaled foreign body (FB)
- Urinary retention
- Gross haematuria
- Renal colic
- Testicular pain
- Priapism
- Paraphimosis
- Necrotizing fasciitis
- Principles of fracture classfication and management
- Compartment syndrome
- Acute abdominal pain in pregnancy
- Paediatric surgical emergencies
- Acute hand injuries
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Summary
Introduction
Renal colic is common, and generally regarded as one of the most painful surgical conditions. It can be life threatening when there is associated urinary sepsis. Exclude a ruptured abdominal aortic aneurysm (AAA) which can have a similar presentation.
Definition and classification
Renal colic most commonly results fromthe presence of a calculus in the upper urinary tract. Interference with normal cyclical peristalsis leads to the classic symptoms of intense colicky pain, stabbing in nature, often with nausea and vomiting.
Incidence (including predisposition according to sex and geography)
The incidence of stone disease is approximately 0.1 to 0.3%. Male to female ratio 3:1. Prevalence 2–3%. Peak incidence 20–40 years. More common in mountainous, desert and tropical areas.
Aetiology
The most common cause of renal colic is a ureteric stone. Other causes include blood clots (clot colic), and a sloughed renal papilla (associated with diabetes, sickle-cell disease). Partially obstructing ureteric transitional cell carcinomas can present with similar symptoms.
Pathogenesis (macro/microscopic pathology)
For stones to form, urine must be supersaturated with the salt that can then form crystals and ultimately the stone. Hypercalciuria (secondary to hypercalcaemia e.g. hyperparathyroidism, immobility), hyperoxaluria and hyperuricaemia may predispose to stone formation. Foreign bodies (e.g. ureteric stents) and certain proteins may form a framework for crystal deposition. The commonest types of stone are: calcium (oxalate, phosphate and mixed) 70%, infection stones (magnesium ammonium phosphate or struvite stones, associated with urease splitting organisms such as Proteus, leading to a high urinary pH and occasionally staghorn calculi) 15–20%, uric acid 5–10%, cystine 1–5% (autosomal recessive inheritance).
- Type
- Chapter
- Information
- Hospital SurgeryFoundations in Surgical Practice, pp. 291 - 295Publisher: Cambridge University PressPrint publication year: 2009