2026-06-03T01:52:48Z https://www.peertechzpublications.org/oai-pmh

oai:www.peertechzpublications.org:10.17352/2455-5495.000008 2016-02-01 PTZ.ARDM:VOL2

Acute Management of Renal Colic and Compliance with National Standards: Closure of the Audit Loop Goonewardene SS P Rajjayabun<p>Renal (ureteric) colic is a common surgical emergency. It is usually caused&nbsp; by&nbsp; calculi&nbsp; obstructing&nbsp; the&nbsp; ureter,&nbsp; but&nbsp; about&nbsp; 15%&nbsp; of&nbsp; patients have&nbsp; other&nbsp; causes,&nbsp; e.g.&nbsp; extrinsic&nbsp; compression,&nbsp; intramural&nbsp; neoplasia or an anatomical abnormality [1]. Up to 12 percent of the population will&nbsp; have&nbsp; a&nbsp; urinary&nbsp; stone&nbsp; during&nbsp; their&nbsp; lifetime,&nbsp; and&nbsp; recurrence&nbsp; rates approach&nbsp; 50&nbsp; percent&nbsp; [2].&nbsp; Fifty-five&nbsp; percent&nbsp; of&nbsp; those&nbsp; with&nbsp; 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&amp;E department, suspected acute renal colic patients must have a&nbsp; clinical&nbsp; examination&nbsp; and&nbsp; radiological&nbsp; investigations&nbsp; to&nbsp; confirm&nbsp; the diagnosis [5]. <br></p><p>The&nbsp; best&nbsp; imaging&nbsp; study&nbsp; to&nbsp; confirm&nbsp; the&nbsp; diagnosis&nbsp; of&nbsp; a&nbsp; urinary stone&nbsp; in&nbsp; a&nbsp; patient&nbsp; with&nbsp; acute&nbsp; flank&nbsp; pain&nbsp; is&nbsp; unenhanced,&nbsp; helical&nbsp; CT&nbsp; of the&nbsp; abdomen&nbsp; and&nbsp; pelvis&nbsp; [6].&nbsp; If&nbsp; CT&nbsp; is&nbsp; unavailable,&nbsp; plain&nbsp; abdominal radiography&nbsp; should&nbsp; be&nbsp; performed,&nbsp; since&nbsp; 75&nbsp; to&nbsp; 90&nbsp; percent&nbsp; of&nbsp; 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&nbsp; used&nbsp; routinely&nbsp; but&nbsp; is&nbsp; appropriate&nbsp; as&nbsp; the&nbsp; initial&nbsp; imaging&nbsp; test&nbsp; when colic occurs during pregnancy [7]. </p> Archives of Renal Diseases and Management - Peertechz Publications 2016-02-01 Research Article https://doi.org/10.17352/2455-5495.000008 en Copyright © Goonewardene SS P Rajjayabun et al.