Renal colic

Renal colic is a cramping pain attack that occurs suddenly, without any predisposing symptoms and is directly related to a violation of urinary outflow from the kidney. In most cases, the attack is caused by the presence of stones in the ureter, pelvis or in the kidney itself. Often, pain can be accompanied by a violation of urination( rapid and painful), nausea and vomiting. In some cases, the pain can cease as suddenly as it appeared, but more often it subside gradually, goes into a dull, and then exacerbates again. It is accompanied by a bloating and a complicated withdrawal of gases.

According to statistics of urgent medical care, renal colic is the second in frequency after acute appendicitis( not counting various injuries)

Etiology and Pathogenesis

The causes may be:

- Various inflammatory processes calyx - pelvis

system - violates the passage of urine sharplyEmerging mechanical obstructions

- Reactive allergic events in the mucosa of the upper urinary tract

- Hemodynamic disorders in the kidney that cause venous a ischemia and thromboembolic processes in the vessels of the kidney

- Spastic phenomena arising reflex in the upper urinary tract with myocardial infarction, appendicitis, cholecystitis, etc.

The causes of renal colic can be: pyelonephritis, urolithiasis, nephroptosis, disturbance of mineral metabolism, hydronephrosis , pelvic tumor and kidney malformations, prostate disease , post radial ureteral stricture, tuberculosis of genitourinary system, periuretYerit. In about 38% of recorded cases - the exact cause of colic can not be established

Symptoms

- A sharp pain in the region of an edge - vertebral angle, which sometimes descends, moving in the groin

- Due to the movement of the stone pain is much greater than inIts motionless state

- With intestinal or biliary colic - painful change, and with renal - constant with short moments of relief and mandatory return of pain

- Depending on the movementI stone, the pain can vary and the patient can quite pinpoint areas of maximum pain, which will be located

stone - there are frequent urination, dysuria, hematuria, oliguria

- nausea and vomiting

Pain in renal colic is divided into three phases:

Acute phase. In most cases, it occurs at night or early in the morning. The pain is permanent, although short-term periods of its sharp increase are possible. The maximum intensity of pain from half an hour to six hours.

Constant phase. Usually lasts from one to four hours, but it can last up to twelve hours. Most people during this time usually turn to honey. Help.

Phase of extinction. It usually lasts from one to three hours. Pain sensations in this phase are less pronounced

Treatment

Treatment is primarily aimed at eliminating obstruction and eliminating pain. At home, in addition to the introduction of antispasmodics, to treat renal colic is unacceptable.

In a hospital administered analgesics( promedol, Baralginum, droperidol, analgin, tramadol, maksigan, procaine, etc.), Spasmolytics( most frequently Nospanum, papaverine hydrochloride, atropine sulfate, spazmoverin, Halidorum, aminophylline ave.), As well as intramuscularly(In severe cases, injected intravenously), various lytic mixtures are administered. For relief of pain, diclofenac sodium is used.

also shown in renal colic: conducting heat treatments( hot-water bottle on the abdomen and lower back, and hot baths), the men held novocaine blockade of the spermatic cord and in women intrabasin block or blockade of the round ligament.

However, thermal procedures are categorically contraindicated for elderly persons, with the presence of tumors of any localization, with cardiovascular insufficiency, micro / macrohematuria.

In case of ineffectiveness of conservative therapy, resort to surgical treatment.

Indications for surgical intervention:

- Large stiffening stone

- Obstructive anuria

- Acute purulent pyelonephritis

- Renal colic with a single kidney