21.3
Renal Colic
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 21, Renal Conditions.
Clinical Description
The syndrome caused by stone(s) passage down the urinary tract. Typically affecting males aged 20 – 40. Colicky abdominal pain (often very severe), radiating from loin to groin (especially as stones moves toward the vesico-ureteric junction.
Signs and Symptoms
- Nausea and vomiting are common. Renal angle tenderness, hematuria (often macroscopic), dysuria and symptoms of UTI.
Investigations
- Full blood count
- Urea, creatinine and electrolytes including calcium
- Serum Uric acid
- Urine dipstick and microscopy
- Abdominal erect xray
- KUB Ultrasound
Treatment
- Intravenous fluids
- Give Morphine or Pethidine. (Section 24.9)
- Give Hyoscine butylbromide 20 mg deep IM stat
- Consider Sodium bicarbonate 1 sachet 24 hourly
- Repeat after 30 minutes if necessary
- Ensure fluid intake of 3-4 litres/day after the crisis
- Intravenous Pyelography is usually indicated
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