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Sample records for acute renal colic

  1. Ultrasonographic diagnosis of acute renal colic

    To assess the sensitivity and specificity of these two methods used separately or in combination in the diagnosis of acute renal colic. Both a B-mode US study (hydronephrosis and calculus detection) and a duplex Doppler US study (RI and RI) were performed in 121 patients diagnosed as having acute renal colic and in 70 healthy individuals. The B-mode US revealed the presence of hydronephrosis in 93.4% of the patients and the calculus was detected in 4.8%. The DDU study demonstrated that 70.2% of the patients had a R=> 0.70 and 68.6% had dRI=>0.06; 79.3% had one or the other of these two values. The specificity was 92.8% with respect to the group of healthy individuals. Every patient (100%) presented some B-mode or duplex US sign. DDU used alone in the diagnosis of acute renal colic does not improve the sensitivity with respect to B-mode US. However, the combination of B-mode US and DDU clearly improves the sensitivity of this diagnostic method. (Author)

  2. COLOUR DOPPLER EVALUATION OF ACUTE RENAL COLIC

    Vallepu Ramaiah

    2016-05-01

    Full Text Available AIMS Can Doppler index–RI be a predictor of renal colics impending obstruction in acute and emergency clinical settings. To compare the results of RI in cases of obstructive, nondilated and normal kidneys. METHODS A total of 90 patients were included in this prospective study. The patients were grouped into three categories based on the clinical settings. Group 1 with acute unilateral obstruction were 44, group 2 who were presented with flank pain without stone disease were 26 and group 3 were 20 patients with sonologically normal kidneys. Grey scale ultrasonography and colour Doppler study carried out in all the groups and index – RI value were compared. RESULTS The study showed differences in RI values among the groups (0.726±0.04, 0.63±0.039 and 0.608±0.03 respectively. CONCLUSION In acute and emergency clinical setting, grey scale ultrasonography and interrogation with colour Doppler index– RI improved the assessment and detection of impending obstructive uropathy.

  3. Intranasal Fentanyl for Analgesia in Adults with Acute Renal Colic

    Massimiliano Etteri; Andrea Bellone

    2012-01-01

    Objectives: The usual treatment of pain in acute renal colic is analgesic in intravenous (IV) route. We tried a rapid, non painful, non-invasive route of administration using intranasal fentanyl versus IV standard treatment (non steroidal anti-inflammatory drug (NSAIDs) plus morphine) for the relief of pain in renal colic presenting to an Emergency Department (ED). Methods: We conducted a prospective non-blinded randomized clinical trial. A sample of 63 adult patients with clinical diagnosis ...

  4. Efficacy and safety of parecoxib in the treatment of acute renal colic: a randomized clinical trial

    Sidney Glina; Ronaldo Damiao; Joao Afif-Abdo; Carlos Francisco Santa Maria; Raúl Novoa; Carlos Eurico Dornelles Cairoli; Dalia Wajsbrot; Gaston Araya

    2011-01-01

    PURPOSE: Although nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs) and opioids are effective treatments for acute renal colic, they are associated with adverse events (AEs). As cyclooxygenase-2 selective NSAIDs may provide a safer alternative, we compared the efficacy and safety of parecoxib versus an nsNSAID in subjects with acute renal colic. MATERIALS AND METHODS: Phase IV., multicenter, double-blind, noninferiority, active-controlled study: 338 subjects with acute renal colic ...

  5. An Evaluation of the Efficacy of Lornoxicam in Acute Renal Colic Treatment

    TEMELTAŞ, Gökhan; ASAN, Çağrı; Müezzinoğlu, Talha; Büyüksu, Coşkun

    2008-01-01

    Purpose: In order to provide analgesia in renal colic, related to acute urinary obstruction, many different agents are used. Use of prostaglandin synthesis inhibitors is very common for this purpose. In our study, we aim to evaluate the analgesic effect of lornoxicam, included in above mentioned group, in renal colic treatment. Materials and Methods: The patients, who were taken to emergency room due to renal colic, were assigned into two group. Before any treatment, they were evaluated w...

  6. Sublingual buprenorphine for acute renal colic pain management: a double-blind, randomized controlled trial

    Payandemehr, Pooya; Jalili, Mohammad; Mostafazadeh Davani, Babak; Dehpour, Ahmad Reza

    2014-01-01

    Background The aim of this study was to compare the efficacy and safety of sublingual buprenorphine with intravenous morphine sulfate for acute renal colic in the emergency department. Methods In this double-dummy, randomized controlled trial, we enrolled patients aged 18 to 55 years who had a clinical diagnosis of acute renal colic. Patients received either 2 mg sublingual buprenorphine with an IV placebo, or 0.1 mg/kg IV morphine sulfate with a sublingual placebo. Subjects graded their pain...

  7. Low dose computed tomography in suspected acute renal colic

    Meagher, Tom; Sukumar, V.P.; Collingwood, Jackie; Crawley, Therese; Schofield, David; Henson, John; Lakin, Ken; Connolly, Dan; Giles, John

    2001-11-01

    Aim: To evaluate whether computed tomography (CT) of the renal tract in suspected renal colic using reduced exposure factors maintains diagnostic accuracy. METHODS: Prospective multi-centre cohort study. Patients with suspected renal colic were examined using computed tomography (CT) of the renal tract followed by intravenous urography (IVU) in four different centres with five different CT systems. RESULTS: Sixty-nine patients with suspected renal colic had CT of the renal tract followed by IVU. CT was performed with reduced exposure factors, giving a mean CT effective dose of 3.5 (range 2.8-4.5) mSv compared with 1.5 mSv for IVU. Ureteric calculi were detected in 43 patients: CT and IVU detected 40 (93%) ureteric calculi. CT identified other lesions causing symptoms in five patients and identified renal calculi in 24 patients. IVU identified renal calculi in six patients and made false positive diagnosis of renal calculi in seven patients. Mean examination time for CT was 5 minutes and for IVU was 80 minutes. CONCLUSION: CT examination at reduced exposure factors maintains the diagnostic accuracy recorded in other series. Meagher, T. et al. (2001)

  8. Low dose computed tomography in suspected acute renal colic

    Aim: To evaluate whether computed tomography (CT) of the renal tract in suspected renal colic using reduced exposure factors maintains diagnostic accuracy. METHODS: Prospective multi-centre cohort study. Patients with suspected renal colic were examined using computed tomography (CT) of the renal tract followed by intravenous urography (IVU) in four different centres with five different CT systems. RESULTS: Sixty-nine patients with suspected renal colic had CT of the renal tract followed by IVU. CT was performed with reduced exposure factors, giving a mean CT effective dose of 3.5 (range 2.8-4.5) mSv compared with 1.5 mSv for IVU. Ureteric calculi were detected in 43 patients: CT and IVU detected 40 (93%) ureteric calculi. CT identified other lesions causing symptoms in five patients and identified renal calculi in 24 patients. IVU identified renal calculi in six patients and made false positive diagnosis of renal calculi in seven patients. Mean examination time for CT was 5 minutes and for IVU was 80 minutes. CONCLUSION: CT examination at reduced exposure factors maintains the diagnostic accuracy recorded in other series. Meagher, T. et al. (2001)

  9. The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

    Kambiz Masoumi; Ali Asgari Darian; Arash Forouzan; Hassan Barzegari; Fakher Rahim; Maryam Feli; Mehdi Fallah Bagher Sheidaii; Samaneh Porozan

    2014-01-01

    The aim of this study was to compare analgesic effect of intramuscular (IM) sodium diclofenac and intranasal desmopressin combination with IM sodium diclofenac alone in patients with acute renal colic. In this randomized double-blind clinical trial, all patients aged 18 to 55 years who were diagnosed as acute renal colic and met the inclusion and exclusion criteria were randomized into two groups to receive 40 μg intranasal desmopressin spray and 75 mg IM sodium diclofenac combination (Group ...

  10. Ureteritis Cystica: Important Consideration in the Differential Diagnosis of Acute Renal Colic

    Padilla-Fernández, B.; FJ. Díaz-Alférez; M. Herrero-Polo; M. Martín-Izquierdo; JM. Silva-Abuín; MF. Lorenzo-Gómez

    2012-01-01

    Ureteritis cystica is an uncommon cause of acute renal pain. The aetiology remains unclear and the diagnosis may be difficult to establish. We report the case of a 29 year old woman with a history of repeated urinary tract infections presenting with acute renal colic in the absence of lithiasis. We review the diagnostic tools available to make the diagnosis and the recent pertinent literature.

  11. Efficacy and safety of parecoxib in the treatment of acute renal colic: a randomized clinical trial

    Sidney Glina

    2011-12-01

    Full Text Available PURPOSE: Although nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs and opioids are effective treatments for acute renal colic, they are associated with adverse events (AEs. As cyclooxygenase-2 selective NSAIDs may provide a safer alternative, we compared the efficacy and safety of parecoxib versus an nsNSAID in subjects with acute renal colic. MATERIALS AND METHODS: Phase IV., multicenter, double-blind, noninferiority, active-controlled study: 338 subjects with acute renal colic were randomized to parecoxib 40 mg i.v. plus placebo (n = 174 or ketoprofen 100 mg IV plus placebo (n = 164. 338 subjects with acute renal colic were randomized to parecoxib 40 mg IV (n = 174 or ketoprofen 100 mg IV(n = 164 plus placebo. Subjects were evaluated 15, 30, 45, 60, 90 and 120 minutes after treatment start and 24 hours after discharge. Primary endpoint was the mean pain intensity difference (PID at 30 minutes by visual analog scale (VAS (per-protocol population. An ANCOVA model was used with treatment group, country, and baseline score as covariates. Non-inferiority of parecoxib to ketoprofen was declared if the lower bound of the 95% confidence interval (CI for the difference between the two groups excluded the pre-established margin of 10 mm for the primary endpoint. RESULTS: Baseline demographics were similar. The mean (SD mPID30 min was 33.84 (24.61 and 35.16 (26.01 for parecoxib and ketoprofen, respectively. For treatment difference (parecoxib-ketoprofen the lower bound of the 95% CI was 6.53. The mean change from baseline in VAS 30 minutes after study medication was ~43 mm; AEs were comparable between treatments. CONCLUSIONS: Parecoxib is as effective as ketoprofen in the treatment of pain due to acute renal colic, is well tolerated, and has a comparable safety profile.

  12. Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

    Sayani R; Ali M.; Shazlee K; Hamid RS; Hamid K

    2011-01-01

    Raza Sayani1, Muhammad Ali1, Kashif Shazlee2, Rana Shoaib Hamid1, Kamran Hamid21Radiology Department, Aga Khan University Hospital, 2Radiology Department, Ziauddin Hospital, Karachi, PakistanPurpose: To determine the role of duplex Doppler ultrasonography (DDU) in patients with acute unilateral renal obstruction.Subjects and methods: A total of 161 patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU). The mean intra-arterial res...

  13. The Comparison of Apotel plus Low Dose of Morphine and Full Dose of Morphine in Pain Relief in Patients with Acute Renal Colic

    Morteza-Bagi, Hamid Reza; Amjadi, Mohsen; Mirzaii-Sousefidi, Reyhaneh

    2015-01-01

    Background Renal colic is an acute flank pain which may radiate to the groin, lower abdomen, or external genitalia due to the passage of a urinary stones. Pain management is the most important task in emergency wards when a patient with renal colic attends. This study aims to compare intravenous acetaminophen plus a low dose of morphine with a full dose of morphine in renal colic. Methods In present randomized clinical trial, 100 patients with confirmed renal colic were recruited from the Eme...

  14. The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

    Kambiz Masoumi

    2014-01-01

    Full Text Available The aim of this study was to compare analgesic effect of intramuscular (IM sodium diclofenac and intranasal desmopressin combination with IM sodium diclofenac alone in patients with acute renal colic. In this randomized double-blind clinical trial, all patients aged 18 to 55 years who were diagnosed as acute renal colic and met the inclusion and exclusion criteria were randomized into two groups to receive 40 μg intranasal desmopressin spray and 75 mg IM sodium diclofenac combination (Group A or 75 mg IM sodium diclofenac alone (Group B. The pain score of patients was assessed using a visual analogue scale (VAS at baseline, 15, 30, 45, and 60 minutes after administration. Of all 159 patients who were assessed for eligibility finally, the results of 120 patients were analyzed. There was no significant difference regarding age and gender between two groups. The baseline VAS score was not significantly different between two groups (P=0.44. The Mean ± SD scores of two groups reduced 15 minutes after drug administration, but this decrease was significantly more in Group A compared with Group B (P=0.02. This pattern continued in minutes 30, 45, and 60 of drug administration. Our results showed that desmopressin could be used as an effective adjuvant in acute renal colic pain management.

  15. Analgesic Effects and Safety of Desmopressin, Tramadol and Indomethacin in Patients with Acute Renal Colic; A Randomized Clinical Trial

    Mehdi Shirazi; Mehdi Salehipour; Mohammad Amin Afrasiabi; Alireza Aminsharifi

    2015-01-01

    Objective: To compare the efficacy of desmopressin (DDAVP), tramadol and indomethacin on pain intensity of patients with acute renal colic caused by urolithiasis. Methods: This prospective, randomized clinical trial was conducted between July 2005 and July 2006 including 120 patients (70 men and 50 women, mean age 38.2±5.8 years) referring to emergency room of Shahid Faghihi hospital with renal colic caused by urolithiasis without any previous treatment. The patients were randomly assigned...

  16. Lornoxicam versus diclofenac sodium in acute renal colic: a prospective randomized trial

    Sushila Godara

    2013-04-01

    Full Text Available Background: Acute renal colic is excruciatingly painful event, opioid analgesics and nonsteroidal anti-inflammatory drugs remain the mainstay of treatment for acute renal colic. This study compares diclofenac and lornoxicam in their efficacy to relieve pain of renal origin. Methods: Prospective, randomized, double blind clinical study including eighty patients with renal pain admitted in emergency department of a tertiary care teaching hospital. Parameters were observed at baseline and after 15, 30, 60, 180 minutes and 5hrs of drug treatment. The efficacy of the drug was measured by observing: Pain score, onset & duration of action, rescue drug use, global patient and physician impression. Results: Both drugs are effective in relieving pain of renal origin (p<0.05 and maintaining it over time as well. When decrease in value of pain score compared between two groups at various interval there was statistically significant (p<0.05 decrease in pain score only at 15 minutes in lornoxicam group showing this slightly more effective in early phase compared to diclofenac. In either group there is no statistically significant difference regarding onset of action, duration of action and side effect profile. Conclusions: Both the drugs are equally effective and safe in renal colicky pain with added advantage of lornoxicam being more effective in early period. [Int J Basic Clin Pharmacol 2013; 2(2.000: 193-198

  17. Unenhanced computed tomography in acute renal colic reduces cost outside radiology department

    Lauritsen, J.; Andersen, J.R.; Nordling, J.;

    2008-01-01

    BACKGROUND: Unenhanced multidetector computed tomography (UMDCT) is well established as the procedure of choice for radiologic evaluation of patients with renal colic. The procedure has both clinical and financial consequences for departments of surgery and radiology. However, the financial effec......) saved the hospital USD 265,000 every 6 months compared to the use of IVU. CONCLUSION: Use of UMDCT compared to IVU in patients with renal colic leads to cost savings outside the radiology department Udgivelsesdato: 2008/12...

  18. Analysis of therapeutic effect of acupuncture at Neiguan(PC 6) and Zusanli(ST 36) on acute renal colic

    琚保军

    2013-01-01

    Objective To observe the efficacy differences among acupuncture at Neiguan(PC 6) and Zusanli(ST 36),dolantin and scopolamine in treatment of acute renal colic,and to verify the clinical effect of acupuncture at Neiguan(PC 6) and Zusanli(ST 36). Methods Two hundred and

  19. Renal infarction in patients presenting with suspected renal colic *

    Seetho, Ian W.; Bungay, Peter M.; Taal, Maarten W.; Fluck, Richard J.; Leung, Janson C. H.

    2009-01-01

    Acute renal infarction is a serious medical emergency. The diagnosis is often delayed or missed as it is not common. Hence, the exact incidence of acute renal infarction is not known. Failure to consider renal infarction in the initial differential diagnosis results in a delay in diagnosis and treatment, which in turn leads to permanent loss of renal function. We present two cases of acute kidney infarction that were initially treated as renal colic. In addition, we present a third case when ...

  20. Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

    Sayani R

    2011-12-01

    Full Text Available Raza Sayani1, Muhammad Ali1, Kashif Shazlee2, Rana Shoaib Hamid1, Kamran Hamid21Radiology Department, Aga Khan University Hospital, 2Radiology Department, Ziauddin Hospital, Karachi, PakistanPurpose: To determine the role of duplex Doppler ultrasonography (DDU in patients with acute unilateral renal obstruction.Subjects and methods: A total of 161 patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU. The mean intra-arterial resistive index (RI and the difference of mean resistive index between both kidneys (delta RI were determined for each person. An RI value of ≥0.70 and a delta RI value of ≥0.06 were taken as the discriminatory threshold for obstruction. IVU results were considered the “reference standard” against which renal DDU findings were compared.Results: IVU showed both kidneys to be normal in 51 patients and with unilateral ureteric obstruction in 110 patients. The mean RI for obstructed kidneys was 0.67 (0.048, which was significantly higher (P-value < 0.05 than a mean RI of contralateral normal kidneys 0.59 (0.04. The mean delta RI in patients with unilateral ureteric obstruction was significantly higher than that in patients with normal kidneys, at 0.076 (0.03 and 0.03 (0.05, respectively. In patients with complete obstruction, sensitivity of RI and delta RI were 77.5% and 92.5% with a specificity of 84.3% and 90.1%, respectively. In patients with partial obstruction, the sensitivity of these values was 22.8% and 62.8% with a specificity of 84.3% and 90.1%.Conclusion: Delta RI is more sensitive and specific than RI in acute renal obstruction. However, due to relatively low sensitivity for detection of partial obstruction, DDU cannot replace IVU as the standard imaging technique.Keywords: renal colic, Doppler ultrasonography, resistive index

  1. Management of acute renal colic in the UK: a questionnaire survey

    Skinner Chas

    2004-12-01

    Full Text Available Abstract Background There is great variation in the Accident and Emergency workload and location of Urology services in UK hospitals. This study investigated the relationship of the initial management of acute renal colic with the department workload plus local facilities including location of X-ray and urology services in UK Accident and Emergency (A&E departments. Methods A&E departments in each of the 11 UK Deanery regions were stratified based on departmental workload, namely small; 30,000 to 50,000 (medium; 50,000 to 80,000 (large and >80,000 (very large patients per year. One third of departments were selected in each group leading to a sample size of 106. A questionnaire was administered. Associations between categorical variables were investigated using the chi-squared test and when not valid, Fisher's Exact test was employed. Differences between groups in ordinal variables were investigated using the Mann-Whitney test. Results All questionnaires were returned. Twenty-nine units (27.4% did not perform any radiological investigation on renal colic patients. The number of radiological investigations that were available to departments was associated with workload (P = 0.003; with 57.1% of the small departments performing none and at least 82.8% of units in the other categories performing at least one. Of those departments with X-ray facilities in or adjacent to the department, 63% performed an intravenous urography (IVU compared to 25% of those departments without (P = 0.026. Of those departments with on-site urology services, 86% performed at least one radiological investigation compared to 52% of units without such services (P = 0.001. Department workload was associated with the first choice analgesia (NSAIDs or parenteral opiates (P = 0.011. Of the small departments, 64.3% used NSAIDs, 21.4% used parenteral opiates and 14.3% used neither. In comparison, NSAIDS were used by at least 87%, and opiates by at most 12.5% of units in each of

  2. Unenhanced multidetector CT (CT KUB) in the initial imaging of suspected acute renal colic: evaluating a new service

    Chowdhury, F.U. [Departments of Clinical Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); Kotwal, S. [Urology, Leeds Teaching Hospitals, Leeds (United Kingdom); Raghunathan, G.; Wah, T.M. [Departments of Clinical Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); Joyce, A. [Urology, Leeds Teaching Hospitals, Leeds (United Kingdom); Irving, H.C. [Departments of Clinical Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom)], E-mail: henry.irving@leedsth.nhs.uk

    2007-10-15

    Aim: To evaluate a new imaging pathway for the investigation of patients presenting with suspected acute renal colic. Materials and methods: A retrospective review of 500 consecutive cases of suspected acute renal colic was undertaken to evaluate the initial results of a new imaging pathway introduced at our institution, which completely replaced the intravenous urogram (IVU) with unenhanced multidetector CT (CT KUB). Results: The positive rate for urolithiasis was 44% (221/500), the negative rate 46% (229/500) and the rate of other significant findings was 12% (59/500). Female patients had a low positive rate compared with male patients (27.5 versus 57.5%; p < 0.001). Urological intervention was required in 28% (61/221) and these patients had a larger average stone size (6.6 versus 3.7 mm; p < 0.001) and the stone was located more proximally. Out-of-hours imaging was performed in 37% (186/500), and these patients had a higher positive rate (52 versus 40%; p < 0.001). Other findings included a wide range of acute non-urological conditions. Conclusion: The feasibility of replacing the acute IVU with CT KUB in the initial assessment of suspected acute renal colic was demonstrated in the present study. The technique enables rapid diagnosis of urolithiasis, stratification of patients likely to proceed to urological intervention, and prompt diagnosis of a variety of other acute pathological conditions.

  3. A comparison of the effect of intranasal desmopressin and intramuscular hyoscine N-butyl bromide combination with intramuscular hyoscine N-butyl bromide alone in acute renal colic

    Abdol-Reza Kheirollahi; Mohammad Tehrani; Mohammad Bashashati

    2010-01-01

    Background: Patients with acute renal colic usually require immediate diagnosis and treatment. In this clinical trial analgesic effect of hyoscine N-butyl bromide and desmopressin combination in comparison with hyoscine N-butyl bromide alone in patients with acute renal colic induced by urinary stones was assessed. Methods: The study included 114 patients randomly allocated in two groups (A and B). Patients in group A received 20 mg intramuscular hyoscine N-butyl bromide at admission tim...

  4. Efficacy and Tolerability of Fixed-Dose Combination of Dexketoprofen and Dicyclomine Injection in Acute Renal Colic

    Porwal, A.; A. D. Mahajan; Oswal, D. S.; Erram, S. S.; D. N. Sheth; Balamurugan, S.; V. Kamat; R. P. Enadle; Badadare, A.; Bhatnagar, S. K.; Walvekar, R. S.; Dhorepatil, S.; R. C. Naik; Basu, I; Kshirsagar, S. N.

    2012-01-01

    Objective. To evaluate the efficacy and tolerability of a fixed-dose combination of dexketoprofen and dicyclomine (DXD) injection in patients with acute renal colic. Patients and Methods. Two hundred and seventeen patients were randomized to receive either DXD (n = 109) or fixed-dose combination of diclofenac and dicyclomine injection (DLD; n = 108), intramuscularly. Pain intensity (PI) was self-evaluated by patients on visual analogue scale (VAS) at baseline and at 1, 2, 4, 6, and 8 hours. E...

  5. Unenhanced Computed Tomography in Acute Renal Colic Reduces Cost Outside Radiology Department

    Lauritsen, J.; Andersen, J.R.; Nordling, J.; Thomsen, H.S. [Dept.s of Diagnostic Radiology and Urology, Copenhagen Univ. Hospital, Herlev (Denmark)

    2008-12-15

    Background: Unenhanced multidetector computed tomography (UMDCT) is well established as the procedure of choice for radiologic evaluation of patients with renal colic. The procedure has both clinical and financial consequences for departments of surgery and radiology. However, the financial effect outside the radiology dept. is poorly elucidated. Purpose: To evaluate the financial consequences outside of the radiology dept., a retrospective study comparing the ward occupation of patients examined with UMDCT to that of intravenous urography (IVU) was performed. Material and Methods: A total of 594 consecutive patients were admitted for renal colic during two 6-month periods. One hundred seventy-three consecutive patients were examined with IVU in 2000 and 421 with UMDCT in 2005. The only difference between the two groups was the imaging procedure. The duration of hospital stay and pathology findings were registered. Results: In 50% of the patients undergoing UMDCT, a stone was found; a stone was found or suspected in 40% of patients undergoing IVU. Patients undergoing IVU stayed significantly longer in the ward than patients examined by UMDCT (P<0.0001). The new procedure (UMDCT) saved the hospital USD 265,000 every 6 months compared to the use of IVU. Conclusion: Use of UMDCT compared to IVU in patients with renal colic leads to cost savings outside the radiology department.

  6. Unenhanced Computed Tomography in Acute Renal Colic Reduces Cost Outside Radiology Department

    Lauritsen, J.; Andersen, J.R.; Nordling, J.; Thomsen, H.S. (Dept.s of Diagnostic Radiology and Urology, Copenhagen Univ. Hospital, Herlev (Denmark))

    2008-12-15

    Background: Unenhanced multidetector computed tomography (UMDCT) is well established as the procedure of choice for radiologic evaluation of patients with renal colic. The procedure has both clinical and financial consequences for departments of surgery and radiology. However, the financial effect outside the radiology dept. is poorly elucidated. Purpose: To evaluate the financial consequences outside of the radiology dept., a retrospective study comparing the ward occupation of patients examined with UMDCT to that of intravenous urography (IVU) was performed. Material and Methods: A total of 594 consecutive patients were admitted for renal colic during two 6-month periods. One hundred seventy-three consecutive patients were examined with IVU in 2000 and 421 with UMDCT in 2005. The only difference between the two groups was the imaging procedure. The duration of hospital stay and pathology findings were registered. Results: In 50% of the patients undergoing UMDCT, a stone was found; a stone was found or suspected in 40% of patients undergoing IVU. Patients undergoing IVU stayed significantly longer in the ward than patients examined by UMDCT (P<0.0001). The new procedure (UMDCT) saved the hospital USD 265,000 every 6 months compared to the use of IVU. Conclusion: Use of UMDCT compared to IVU in patients with renal colic leads to cost savings outside the radiology department

  7. 急性肾绞痛的微创治疗%Minimally Invasive Treatment of Acute Renal Colic

    李辉明; 魏世平

    2015-01-01

    Objective:To summarize the minimally invasive treatment methods of acute renal colic.Method:The clinical diagnosis and treatment process of 75 cases of acute renal colic patients from January 2006 to December 2014 in our hospital were analyzed retrospectively,the urinary CT scan + 3D reconstruction wss the core of the inspection method,ureteroscopic as the main minimally invasive treatment methods.Result:75 cases of urinary calculi,65 cases with urinary calculi complication with renal colic were diagnosed by CT,with emergency ureteroscopy,expansion,indwelling double J tube,holmium laser lithotripsy and holmium laser lithotripsy,occluder different minimally invasive operation method to relieve renal colic,5 cases with auxiliary extracorporeal lithotripsy(ESWL), postoperative hospitalization time was 3-7 days,average 4 days,no postoperative complications.The other 5 patients diagnosis for abdominal aortic aneurysm(2 cases),acute pancreatitis(1 case),stone(1 case),renal tumor(1 case) were given corresponding treatment in time.Conclusion:The new thinking method of urinary CT diagnosis,emergency ureteroscopic minimally invasive treatment of renal colic have advantages with fasting,efficience,safety and prevention clinical misdiagnosis and missed diagnosis of acute abdomen,which is a minimally invasive method for relieving acute renal colic.%目的:总结急性肾绞痛的微创治疗方法。方法:回顾性分析2006年1月-2014年12月笔者所在医院收治的75例急性肾绞痛患者的临床诊治过程,采用以泌尿系CT平扫+三维重建为核心的检查方法和急诊输尿管镜为主的微创治疗。结果:75例患者中,65例患者通过CT确诊为泌尿系结石合并肾绞痛后通过急诊输尿管镜检查、扩张、留置双J管、钬激光碎石、封堵器+钬激光碎石等不同微创手术方法解除肾绞痛,5例辅助体外碎石(ESWL),术后住院时间3~7 d,平均4 d,术后无并发症;另5例患者

  8. Intravenous indomethacin and oxycone-papaverine in the treatment of acute renal colic. A double-blind study.

    Jönsson, P E; Olsson, A M; Petersson, B A; Johansson, K

    1987-05-01

    In a prospective double-blind, cross-over study, 61 patients with acute renal colic were treated with either indomethacin (50 mg) or oxycone-papaverine (5 mg + 50 mg) administered intravenously. For those patients requiring a second injection the drugs were reversed. The intensity of pain was evaluated before and 20 min after each injection according to an analogue visual scale 0 to 100. Both drug regimens provided comparable and significant pain relief; a pain score of less than 20 appeared to be satisfactory and was achieved in almost all cases. PMID:3297230

  9. Comparison of Clinical Efficacy of Intravenous Acetaminophen with Intravenous Morphine in Acute Renal Colic: A Randomized, Double-Blind, Controlled Trial

    Kambiz Masoumi; Arash Forouzan; Ali Asgari Darian; Maryam Feli; Hassan Barzegari; Ali Khavanin

    2014-01-01

    The aim of this study was to compare the clinical efficacy of intravenous acetaminophen with intravenous morphine in acute renal colic pain management. In this double-blind controlled trial, patients aged 18–55 years, diagnosed with acute renal colic, who met the inclusion and exclusion criteria, were randomized into two groups. First, using the visual analogue scale (VAS), intensity of pain was assessed in both groups. Then, one gram of intravenous acetaminophen or 0.1 mg/kg morphine was inf...

  10. Analgesic Effects and Safety of Desmopressin, Tramadol and Indomethacin in Patients with Acute Renal Colic; A Randomized Clinical Trial

    Mehdi Shirazi

    2015-04-01

    Full Text Available Objective: To compare the efficacy of desmopressin (DDAVP, tramadol and indomethacin on pain intensity of patients with acute renal colic caused by urolithiasis. Methods: This prospective, randomized clinical trial was conducted between July 2005 and July 2006 including 120 patients (70 men and 50 women, mean age 38.2±5.8 years referring to emergency room of Shahid Faghihi hospital with renal colic caused by urolithiasis without any previous treatment. The patients were randomly assigned to three groups: group A received tramadol 50mg intramuscularly (n=40, group B received desmopressin 40 µg intranasally (n=40 and group C received indomethacin 100mg rectally (n=40. The pain was assessed both on admission and 30 minutes after the intervention. The pain intensity and the side effects were compared between two study groups. Results: There was no significant difference between two study groups regarding the baseline characteristics. The intensity of pain of presentation was almost similar in all groups. In group A, 30 patients (75%, in group B, 15 patients (37.5% and in group C, 19 patients (47.5% had complete pain relief. The pain intensity decreased significantly after the intervention within all three groups ( p<0.001. Conclusion: According to the results of the current study, rectal indomethacin, intramuscular tramadol and intranasal desmopressin are effective and safe routs of controlling pain in acute renal colic secondary to urolithiasis. Tramadol was the most effective agent in controlling the pain. Clinical Trial Registry: The current study is registered with Iranian Registry for Clinical Trials (www.irct.ir; IRCT2015030919470N18

  11. Efficacy and Tolerability of Fixed-Dose Combination of Dexketoprofen and Dicyclomine Injection in Acute Renal Colic

    A. Porwal

    2012-01-01

    Full Text Available Objective. To evaluate the efficacy and tolerability of a fixed-dose combination of dexketoprofen and dicyclomine (DXD injection in patients with acute renal colic. Patients and Methods. Two hundred and seventeen patients were randomized to receive either DXD (n=109 or fixed-dose combination of diclofenac and dicyclomine injection (DLD; n=108, intramuscularly. Pain intensity (PI was self-evaluated by patients on visual analogue scale (VAS at baseline and at 1, 2, 4, 6, and 8 hours. Efficacy parameters were proportion of responders, difference in PI (PID at 8 hours, and sum of analogue of pain intensity differences (SAPID. Tolerability was assessed by patients and physicians. Results. DXD showed superior efficacy in terms of proportion of responders (98.17% versus 81.48; P<0.0001, PID at 8 hours (P=0.002, and SAPID0–8 hours (P=0.004. The clinical global impression for change in pain was significantly better for DXD than DLD. The incidence of adverse events was comparable in both groups. However, global assessment of tolerability was rated significantly better for DXD. Conclusion. DXD showed superior efficacy and tolerability than DLD in patients clinically diagnosed to be suffering from acute renal colic.

  12. Renal colic: current protocols for emergency presentations.

    Leveridge, Mike; D'Arcy, Frank T; O'Kane, Dermot; Ischia, Joseph J; Webb, David R; Bolton, Damien M; Lawrentschuk, Nathan

    2016-02-01

    Flank pain caused by renal colic is a common presentation to emergency departments. This paper reviews the acute clinical assessment of these patients, outlines appropriate diagnostic strategies with labwork and imaging and updates the reader on conservative treatments, suitable choices for analgesia and indications for surgical intervention. Prompt diagnosis and appropriate treatment instituted in the Emergency Department can rapidly and effectively manage this excruciatingly painful condition. PMID:26367338

  13. [Renal colic: new care in emergency centers].

    Morandi, Eléonore; Kherad, Omar; Chollet, Yves; Dussoix, Philippe

    2016-02-01

    The prevalence of renal colic is increasing in industrialized countries, representing a frequent reason for consultation in emergencies. Most patients have simple renal colic that will require analgesia and ambulatory monitoring. Doctors working in emergency centers play a key role in the diagnosis, care and guidance of these patients. They must identify factors of gravity and request urological advice if necessary. This article summarizes the recent diagnostic and therapeutic innovations in the management and guidance of renal colic in emergency centers. PMID:26999995

  14. [How I TREAT... A RENAL COLIC].

    Lavergne, O; Bonnet, Q; Thomas, A; Waltregny, D

    2016-05-01

    Renal colic (RC) represents nearly 2% of emergency department admissions. RC is defined by the occurrence of back pain which may radiate towards the abdomen and external genitals. In adults, the obstruction is caused by a urinary stone in 80% of cases. The 20 % of non-stone related RCs are due either to an intrinsic obstruction (pyeloureteral junction stenosis, ureteral tumor, ...) or an extrinsic compression (pelvic tumor, lymphadenopathy ...). In over 90% of cases, an RC does not require hospitalization and is treated with medication. In contrast, complicated renal colic (CRC) requires hospitalization with specialized care. Obstructive pyelonephritis (OPN) is a form of CRC and the diagnosis should be considered in a clinical presentation of "renal colic" with acute pyelonephritis. This is a true emergency requiring surgical drainage of the upper urinary tract upstream of the obstacle, as well as antibiotic therapy. It must be kept in mind that some clinical presentations may be atypical, especially in the elderly, which can delay the diagnosis and, thus, the management. The gold standard for diagnosis is CT urography. PMID:27337839

  15. Renal colic: Radiological approach

    Nikolić Olivera

    2006-01-01

    Full Text Available Acute flank pain is commonly caused by urolithiasis. This paper discusses advantages and disadvantages of procedures used for evaluation of acute flank pain. In our institution, the diagnostic algorithm includes ultrasonography and plain film radiog­raphy, and unenhanced spiral CT in equivocal cases. .

  16. Radiologic diagnosis of renal colic

    The accuracy of plain films, excretory urography and ultrasound for the clinical work-up of renal colic for detecting urinary calculi was evaluated prospectively in 49 patients. Excretory urography was the most sensitive and specific test. Plain films and sonography each had a sensitivity of approximately 60 per cent, but combined yielded a sensitivity of 80 per cent; specificity did not improve. A diagnostic algorithm where sonography was performed first followed by an excretory urography in case of a negative sonography was highly sensitive (93 per cent) and rather specific (79 per cent). This algorithm appears also to have a good cost-benefit rate. (author). 11 refs.; 3 tabs

  17. The role of B-Mode ultrasonography in the detection of urolithiasis in patients with acute renal colic

    Haroun Azmi

    2010-01-01

    Full Text Available This study was conducted to assess the diagnostic yield of B-Mode Ultrasonogra-phy compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic. This retrospective study comprised of 156 patients who underwent unenhanced uri-nary tract CT scan and ultrasonography for suspicion of urolithiasis. Both techniques were used to determine the presence or absence, site, size, and number of urinary stones, as well as presence of any other intra-abdominal pathology. For statistical analysis, the sensitivity, specificity, predictive values, and diagnostic accuracy of ultrasonography were measured considering unenhanced CT scan as a gold standard. Unpaired two-tailed student′s t-test was used for comparison between mean size of true positive, false positive, and false negative stones. There were 68 patients having 115 urinary stones. Ultrasound identified 54 stones, missed 43, and falsely diagnosed 18 stones. The mean size of true positive, false positive, and false negative stones were 4.8 ± 3.3 mm, 6 ± 1.8 mm and 4.18 ± 3 mm, respectively. There were 23 patients with other intra-abdominal patho-logies, equally detected by both techniques. Ultrasound helped in identifying the cause of acute flank pain in 62% of cases. The overall sensitivity, specificity, positive and negative predictive values, and accuracy of ultrasonography in the diagnosis of renal stone disease were 58%, 91%, 79%, 78%, and 78% , respectively. Our study suggests that, despite its limited value in detecting urinary stones, ultrasonography should be performed as an initial assessment in patients with acute flank pain. Unenhanced helical CT should be reserved for patients in whom ultrasonography is inconclusive.

  18. Value of ultrasonography in renal colic

    To determine the role of sonography (US) in the patients with renal colic, 40 patients were examined by means of US, plain abdominal film (PF), and intravenous pielography (ivp). US sensitivity was 92.3% in diagnosing hidronephrosis and 75% in detecting calculi. Small calculi were correctly identified, irrespective of their chemical composition. It must be stressed how US, as compared to ivp, proved unsatisfactory in such cases as difficult visualization of the middle portion of the ureter, unsuccessful identification of acute obstruction without hydronephrosis (altough the patient's hydratation may be useful in this respect), poor functional information (although there was a correlation between renal hyperechogenicity and obstructive nephrogram). US is safe and easy to perform, and is suggested for the initial evaluation of patients with renal colic, together with PF, and as an alternative to ivp. Moreover, US is the ideal technique in the follow-up of these patients. Therefore, ivp should be performed in case of differing clinical and sonographic findings, when the calculus is not ejected within the expected time and when surgery or litotripsy are foreseen

  19. Therapeutic Approaches for Renal Colic in the Emergency Department: A Review Article

    Golzari, Samad EJ; Soleimanpour, Hassan; Rahmani, Farzad; Zamani Mehr, Nahid; Safari, Saeid; Heshmat, Yaghoub; Ebrahimi Bakhtavar, Hanieh

    2014-01-01

    Context: Renal colic is frequently described as the worst pain ever experienced, and management of this intense pain is necessary. The object of our review was to discuss different approaches of pain control for patients with acute renal colic in the emergency department. Evidence Acquisition: Studies that discussed the treatment of renal colic pain were included in this review. We collected articles from reputable internet databases. Results: Our study showed that some new treatment approach...

  20. Evaluation of acute renal colic: a comparison of non-contrast CT versus 3-T non-contrast HASTE MR urography.

    Semins, M J; Feng, Z; Trock, B; Bohlman, M; Hosek, W; Matlaga, B R

    2013-02-01

    With the introduction of a 3-T scanner, magnetic resonance urography (MRU) may be an alternative imaging modality for evaluation of acute renal colic. We performed a prospective study to compare the performance of computed tomography (CT) with half-Fourier single shot turbo spin-echo (HASTE) MRU in the evaluation of patients with suspected renal colic. Patients presenting to the emergency department with acute renal colic were eligible for inclusion. Following a standard CT stone evaluation, patients underwent a non-contrast HASTE MRU study with a 3-T scanner. The presence of perinephric fluid, hydronephrosis, ureteral obstruction, and calculus was assessed. A total of 22 patients completed the study. Twenty (91 %) were diagnosed with an upper tract stone by radiographic findings. MRU detected a discrete stone in 50 % of the patients with stones detected by CT. Perinephric fluid was noted in 12 MRUs, compared to 7 CTs. Using CT as the reference standard, the combination of stone or perinephric fluid and ureteral dilation gave MRU a sensitivity of 84 %, specificity of 100 %, and accuracy of 86 % (95 % CI 0.72-1.0). HASTE MRU with a 3-T MR scanner can reliably detect the presence of upper urinary tract obstruction. Although CT imaging remains the superior modality with which to detect calculi, MRU detects a greater number of secondary signs of upper tract obstruction. For situations in which the use of ionizing radiation is undesirable, MRU is a reasonable imaging alternative. PMID:23532422

  1. Ultrasonic findings in diagnosing renal colic

    Lee, Myung Jin; Kim, Mee Hyun; Lee, Young Joong; Yoon, Jong Sup [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    1986-04-15

    To determine diagnostic values of ultrasonography in evaluation of renal colic, ultrasonographic study of 35 patients in whom renal colic was clinically suspected was undertaken. The sonographic criterion for a positive finding consisted of visualization of urinary tract calculus with posterior acoustic shadowing, with or without ureterectasis. Renal colic was correctly diagnosed by ultrasonography in 28 patients of 33 patients with proven ureteric stone, for an accuracy of 85%. Of the 33 patients with proven ureteric stone, there were 3 cases with ureteropelvic junction stone, 4 cases with abdominal ureter stone, 4 cases with iliac ureter stone, 4 cases with pelvic ureter stone and 18 cases with ureterovesical junction stone. The results show that ultrasonography in an effective initial screening test when renal colic is clinically suspected.

  2. Comparing the Efficacy and Adverse Effects of Tramadol and Sodum Diclofenac with pethedine in the Treatment of Renal Colic

    M Rajaei; K Noorian; Madineh; S Madineh

    2013-01-01

    Abstract Background & aim: One of the choice treatments for pain relief in acute renal colic is administration of narcotics, but always the need for low-dose effects are felt difficulties. The aim of this study was to compare the efficacy of sodium diclofenac and pethedine hydrochloride with Tramadol to reduce the pain of acute renal colic. Methods: In this clinical trial study, 150 patients (15-65 years) with acute renal colic referred to Kashani hospital in Shahrekord were selected...

  3. A comparison of the effect of intranasal desmopressin and intramuscular hyoscine N-butyl bromide combination with intramuscular hyoscine N-butyl bromide alone in acute renal colic

    Abdol-Reza Kheirollahi

    2010-01-01

    Full Text Available Background: Patients with acute renal colic usually require immediate diagnosis and treatment. In this clinical trial analgesic effect of hyoscine N-butyl bromide and desmopressin combination in comparison with hyoscine N-butyl bromide alone in patients with acute renal colic induced by urinary stones was assessed. Methods: The study included 114 patients randomly allocated in two groups (A and B. Patients in group A received 20 mg intramuscular hyoscine N-butyl bromide at admission time and patients in group B received 20 μg of intranasal desmopressin in combination with 20 mg intramuscular hyoscine N-butyl bromide. A visual analogue scale (VAS; a 10-cm horizontal scale ranging from "zero or no pain" to "10 or unbearable pain" was hired to assess the patients′ pain severity at baseline, 30 and 60 minutes after the treatments. Results: On admission, the pain level was similar in both groups (group A: 8.95 ± 0.11 and group B: 8.95 ± 0.12. In group A, the mean of pain level showed a decrease after 30 minutes (group A: 7.26 ± 0.25 and group B: 5.95 ± 0.28 but further decreasing did not occur; however in group B, the pain consistently decreased and the mean after 60 minutes was significantly decreased (group A: 6.80 ± 0.31 and group B: 3.71 ± 0.31. No side effects were detected in this study. Conclusions: The combination of hyoscine N-butyl bromide and desmopressin is more effective than hyoscine N-butyl bromide alone in patients with renal colic. Further studies are recommended to validate these findings and compare the different doses of desmopressin.

  4. Evaluation of suspected renal colic

    The authors studied 98 patients with abdominal pain to evaluate ultrasound (US) versus excretory urography (EU) in ureteric colic. All studies were performed and interpreted independently by radiologists blinded to the outcome. Of 85 patients available for follow-up, 44 had calculi (recovered), 28 had presumed calculi, and 13 had noncalculous disease. In 44 patients with definite calculi, Eu findings were positive in 38 and negative in six. US findings were positive in 43 of 44 (either calculus or hydronephrosis identified). The authors conclude that EU and US are both accurate and diagnostic ureteric colic. The convenience of EU and the immediate availability of films makes it the investigation of choice in the initial evaluation of suspected ureteric colic

  5. Management of Patients with Renal Colic in Emergency Department

    Mehmet Oguzhan Ay; Akkan Avci; Selen Acehan; Muge Gulen; Ferhat Icme; Ahmet Sebe

    2014-01-01

    Renal colic is a common emergent urological problem seen in emergency departments, which often occurs due to kidney stone disease and characterized by severe pain. Renal colic is described by the patients as the most painful and debilitating experience of their life. The main purpose of emergency treatment is to control pain effectively, and resolve urinary obstruction without causing loss of renal function. In this compilation, studies regarding the management of patients with renal colic in...

  6. Pharmacological management of renal colic in the older patient.

    Welk, Blayne K; Teichman, Joel M H

    2007-01-01

    Renal colic affects up to 12% of the population. Initial management of most patients is expectant. Acute symptom management of renal colic is best accomplished with a combination of parenteral opioids and NSAIDs. The elderly patient with a kidney stone should be screened for contraindications to NSAID therapy, such as renal failure or previous peptic ulcer disease. Use of parenteral opioids is often necessary during the acute setting, and downward-adjusted doses and monitoring are necessary to prevent associated confusion and respiratory depression. Novel therapy with desmopressin may also be effective for symptom control at the initial presentation, without the adverse effects of opioids or NSAIDs. However, use of desmopressin in the elderly must be undertaken cautiously, given the potential adverse effects of this agent. Many small, distal ureteral stones are treated initially with watchful waiting for the first 2-4 weeks after presentation. The patient should have effective, non-parenteral analgesics for use at home. Included in these agents are oral or suppository NSAIDs and oral opioids. Medical expulsion therapy with alpha-adrenoceptor antagonists or calcium channel antagonists is efficacious. alpha-Adrenoceptor antagonists such as the alpha(1A/)(1)(D)-selective tamsulosin are well tolerated in the elderly and increase the rate of spontaneous stone passage by approximately 50% for small distal stones. These agents also appear to decrease the severity of renal colic. Corticosteroids and calcium channel antagonists are also effective but their use in the elderly is not recommended as first-line therapy. PMID:17953457

  7. Treatment of renal colic by desmopressin intranasal spray and diclofenac sodium.

    el-Sherif, A E; Salem, M; Yahia, H; al-Sharkawy, W A; al-Sayrafi, M

    1995-05-01

    The vasopressin analogue, 1-desamino-8-arginine vasopressin (desmopressin), is a potent antidiuretic without the pressor effects of vasopressin. A total of 18 patients with acute renal colic due to stone disease received 40 microgramsf1p4mopressin intranasal spray with encouraging results. There was a significant decrease in the colic pain intensity from an initial mean visual analogue score of 67 +/- 17 mm. to 39 +/- 36 mm. within 30 minutes (p renal colic is uncertain. At the peripheral level, desmopressin may alleviate the acute renal colic through its potent antidiuretic effect or by relaxing the renal pelvic and ureteral smooth muscles. The central analgesic effect of desmopressin by stimulating the release of the hypothalamic beta-endorphin is proposed. We conclude that intranasal desmopressin spray can be used successfully in the treatment of renal colic. It may also replace prostaglandin synthetase inhibitors in treating renal colic with the advantage of avoiding the potential side effects. Further studies are needed to investigate whether the combination of desmopressin with analgesics or spasmolytic drugs offers competitive results compared with those achieved by prostaglandin synthetase inhibitors in the treatment of renal colic. PMID:7714949

  8. [Treatment of renal colic with intravenous ketoprofen].

    Pourrat, J P; Dueymes, J M; Conte, J J

    1984-10-01

    In view of the part played by renal prostaglandins in the mechanisms responsible for pain in renal colic, it was worth trying to find out whether nonsteroidal anti-inflammatory agents, which inhibit prostaglandin synthesis, have an analgesic effect of their own. In a double-blind trial the effects of ketoprofen 100 mg administered intravenously alone or associated with noramidopyrine were investigated in 62 patients divided at random into two equal groups. A rapid analgesic effect was observed with no significant difference between the groups. No severe side-effects were recorded. The double-blind method made it possible to confirm that ketoprofen administered alone relieved pain in 97% of the patients (with complete sedation in 45%) and acted within 5 minutes. Owing to their effectiveness and safety nonsteroidal anti-inflammatory drugs (especially ketoprofen) may be proposed as an alternative to conventional treatments of renal colic. But because of their activity they should not be prescribed until a firm diagnosis has been made. The cause of the colic should also be rapidly determined in order to treat it as well as the pain it produces. PMID:6238315

  9. A Rare Cause of Acute Kidney Injury in a Female Patient with Breast Cancer Presenting as Renal Colic

    Roxana Jurubita; Bogdan Obrisca; Gener Ismail

    2016-01-01

    Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis), but also in t...

  10. β-Adrenoreceptor agonists in the management of pain associated with renal colic: a systematic review

    Tabner, Andrew John; Johnson, Graham David; Fakis, Apostolos; Surtees, Jane; Lennon, Robert Iain

    2016-01-01

    Objectives To determine whether β-adrenoreceptor agonists are effective analgesics for patients with renal colic through a systematic review of the literature. Setting Adult emergency departments or acute assessment units. Participants Human participants with proven or suspected renal colic. Interventions β-adrenoreceptor agonists. Outcome measures Primary: level of pain at 30 min following administration of the β-agonist. Secondary: level of pain at various time points following β-agonist ad...

  11. Embolic renal infarction mimicking renal colic

    Mahamid M; Francis A.; Abid A; Awawde M; Abu-Elhija O

    2014-01-01

    Mahmud Mahamid,1,3 Adi Francis,2 Ali Abid,1 Mohammed Awawde,1 Omar Abu-Elhija11Department of Internal Medicine, 2Cardiac Care Unit, Holy Family Hospital, Bar-Ilan University, Nazareth, Israel; 3Digestive Disease Institute, Liver Unit, Shaare Zedek Medical Center, Jerusalem, IsraelAbstract: Atrial fibrillation is a major health problem with risk of systemic arterial embolism. Acute embolic renal infarction is a rare condition with symptoms that are often nonspecific. We present a 36-year-old p...

  12. A Rare Cause of Acute Kidney Injury in a Female Patient with Breast Cancer Presenting as Renal Colic.

    Jurubita, Roxana; Obrisca, Bogdan; Ismail, Gener

    2016-01-01

    Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis), but also in the situations when a hypercoagulable state is presumed. The unspecific presenting symptoms often mask the true etiology of the patient's complaints. We present here a rare case of renal infarction that occurred in the setting of a hypercoagulable state, in a female patient with a history of breast cancer and documented hepatic metastases. PMID:27293927

  13. A Rare Cause of Acute Kidney Injury in a Female Patient with Breast Cancer Presenting as Renal Colic

    Roxana Jurubita

    2016-01-01

    Full Text Available Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis, but also in the situations when a hypercoagulable state is presumed. The unspecific presenting symptoms often mask the true etiology of the patient’s complaints. We present here a rare case of renal infarction that occurred in the setting of a hypercoagulable state, in a female patient with a history of breast cancer and documented hepatic metastases.

  14. [Giant renal cyst as cause of colic obstruction].

    Vos, B; Laureys, M

    2009-01-01

    A 97-year old woman presented with a 2-months history of asthenia, loss of appetite, nauseas and intermittent diarrhea. She presented an important colic distension associated to an inflammatory syndrome. Microbiological documentation (blood, urine, saddles stool) was negative. Abdominal computed tomography (CT) showed a 15 cm of diameter (giant) right cortical renal cyst with colic obstruction by external colic compression. A percutaneous cyst drainage was performed allowing the evacuation of 1,500 cc. The fluid culture was positive for Raoultella ornithinolytica and Enterococcus faecalis. No antibiotics were given but inflammatory syndrome remained within normal value. Colic function remained normal. PMID:19517907

  15. Renal colic: is intravenous urography really necessary?

    A prospective study was performed in 47 patients suspected of having renal colic to determine the diagnostic value of ultrasonography in nephrolithiasis. The urinary tract was examined in the attempt to locate the stone and its possible complications (urinoma and functional obstruction). Ultrasound confirmed the diagnosis in 84% of the cases by detecting the stone (n=29) or edema in the ureterovesical junction resulting from its spontaneous expulsion (n=3). It disclosed 80% of the clinically significant urinomas and ruled out functional obstruction with a sensitivity of 87% and a specificity of 100%. Ultrasonography may render unnecessary additional diagnostic tests in those cases in which it confirms the diagnosis and functional obstruction is ruled out. (Author) 19 refs

  16. Imaging patients with renal colic-consider ultrasound first

    Nicolau, Carlos; Claudon, Michel; Derchi, Lorenzo E;

    2015-01-01

    UNLABELLED: Renal colic is a common disease in Europe and a common cause of visit to the Emergency Department. Clinical diagnosis is usually confirmed by imaging modalities. Unenhanced computed tomography (CT) is considered the best diagnostic test due to its excellent accuracy detecting ureteral...... findings such as the asymmetry or absence of ureteric jet, an increase of the resistive index or a colour Doppler twinkling artefact may help to suggest the diagnosis when the stone is not identified. MAIN MESSAGES: • Renal colic diagnosis is usually confirmed by imaging modalities. • Imaging diagnosis of...... renal colic is based on the detection of ureteral stones. • CT is the most accurate imaging technique to identify ureteral stones. • US allows correct diagnosis in most cases without using radiation. • US should be used as the first imaging modality in patients with renal colic....

  17. The Role of Ultrasound in Initial Evaluation of Renal Colic

    Abu-Ghazzeh Yaser; Abdu-Alro'f Salah

    2000-01-01

    The objective of this study is to evaluate the use of ultrasound in the initial evaluation of renal colic. We studied prospectively 21 patients referred for radiographic evaluation for renal colic from January 1998 through April 1998. All sonographic studies were performed with real-time sector scanner (Kertz, Compeson 410 using 3.5 MHz Probe). Our sonographic criteria for a positive examination consisted of the visualization of urinary tract calculus and/or unilateral hydronephrosis with or ...

  18. Morphine Suppository versus Indomethacin Suppository in the Management of Renal Colic: Randomized Clinical Trial

    Forough Zamanian; Mohammad Jalili; Maziar Moradi-Lakeh; Maryam Kia; Rokhsareh Aghili; Seyed Mojtaba Aghili

    2016-01-01

    Background. Renal colic is a medical emergency due to the rapid onset and devastating nature of its pain. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are both used as first-line choices in its management. Aim. This study aimed to compare the efficacy and safety of opioids and NSAIDs in the management of acute renal colic. Methods. One hundred and fifty-eight patients were divided into two groups (n = 79) and received either 10 mg morphine or 100 mg indomethacin suppositories. Th...

  19. Non-contrast spiral CT for patients with suspected renal colic

    Katz, D.S. [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, CA 94305-5105 (United States); Lane, M.J. [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, CA 94305-5105 (United States); Sommer, F.G. [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, CA 94305-5105 (United States)

    1997-06-01

    Renal colic, defined as acute flank pain caused by the passage of a ureteral calculus, is a common condition, but the correct diagnosis may not be apparent clinically. For decades, intravenous urography has been the test of choice for evaluating patients with suspected renal colic. Recently, unenhanced (non-contrast) helical CT has been shown to be an accurate and highly effective examination which can be used instead of intravenous urography. In this article, the technique is reviewed in detail, including its advantages and potential pitfalls. (orig.). With 12 figs.

  20. Non-contrast spiral CT for patients with suspected renal colic

    Renal colic, defined as acute flank pain caused by the passage of a ureteral calculus, is a common condition, but the correct diagnosis may not be apparent clinically. For decades, intravenous urography has been the test of choice for evaluating patients with suspected renal colic. Recently, unenhanced (non-contrast) helical CT has been shown to be an accurate and highly effective examination which can be used instead of intravenous urography. In this article, the technique is reviewed in detail, including its advantages and potential pitfalls. (orig.). With 12 figs

  1. Treatment of Special Renal Colic with Ureteroscope and Holmium YAG Laser

    沈明顺; 刘军

    2002-01-01

    Objective To investigate the method of emergent relief of special renal colicand treatment of ureter diseases causing renal colic. Methods By analyzing 63 cases of special re-nal colic treated with ureteroscope and Holmium YAG laser. Results 61 cases of renal colic were re-lieved in a short period of time and the ariginal ureter diseases causing renal colic were cured. Conclu-sion Special renal colic could be treated with ureteroscope and Holmium YAG laser in a quick and ef-fective manner.

  2. Electroacupuncture Treatment of 50 Patients with Renal Colic

    ZOU Lan-lin

    2003-01-01

    Treated 50 cases of renal colic with electroacupuncture and compared the results with those in two control groups. Total effective rate in the treatment group, control group Ⅰ and control group Ⅱ was 98.0%,90.0% and 92.0% respectively.

  3. Anxiety and depression symptoms in recurrent painful renal lithiasis colic

    D.H.M.P. Diniz; Blay, S. L.; Schor, N.

    2007-01-01

    Several studies have reported that symptoms of anxiety and depression are significantly associated with diseases characterized by painful crises. However, there is little information about the psychological aspects of recurrent painful episodes of renal stone disease. Our objective was to evaluate the association of symptoms of anxiety, depression and recurrent painful renal colic in a case-control study involving 64 subjects (32 cases/32 controls) matched for age and sex. Cases were outpatie...

  4. The Role of Ultrasound in Initial Evaluation of Renal Colic

    Abu-Ghazzeh Yaser

    2000-01-01

    Full Text Available The objective of this study is to evaluate the use of ultrasound in the initial evaluation of renal colic. We studied prospectively 21 patients referred for radiographic evaluation for renal colic from January 1998 through April 1998. All sonographic studies were performed with real-time sector scanner (Kertz, Compeson 410 using 3.5 MHz Probe. Our sonographic criteria for a positive examination consisted of the visualization of urinary tract calculus and/or unilateral hydronephrosis with or without ureterectasis. The presence of urinary calculi was proven in 18 out of 21 patients (85%. The absence of calculi was established in three cases either by negative I.V.U. (2 cases or by the clinical and sonographic demonstration of epididymitis as the cause in one patient. In the 18 patients with proven urinary calculi, ultrasound correctly identified the diagnosis in 15 cases (83%. Of those 15 visualized calculi, 11 were located at the ureterovesicular junction, two in the renal pelvis, one in the proximal third of the ureter, and one in the distal third. The sensitivity of ultasonography to detect renal calculi was 83% and the specificity, 100%. The one false positive examination with unilateral hydronephrosis proved to be due to a retroperitoneal liposarcoma. There were two cases in which the urinary tract ultrasound examination was negative. We conclude that ultrasound has a high diagnostic value when used as the first line investigation for the initial evaluation of renal colic.

  5. Low-Dose and Standard-Dose Unenhanced Helical Computed Tomography for the Assessment of Acute Renal Colic: Prospective Comparative Study

    Kim, Bong Soo; Hwang, Im Kyung; Choi, Yo Won; Namkung, Sook; Kim, Heung Cheol; Hwang, Woo Cheol; Choi, Kuk Myung; Park, Ji Kang; Han, Tae Il; Kang, Weechang [Cheju National Univ. College of Medicine, Jeju (Korea, Republic of). Dept. of Diagnostic Radiology

    2005-11-01

    Purpose: To compare the efficacy of low-dose and standard-dose computed tomography (CT) for the diagnosis of ureteral stones. Material and Methods: Unenhanced helical CT was performed with both a standard dose (260 mAs, pitch 1.5) and a low dose (50 mAs, pitch 1.5) in 121 patients suspected of having acute renal colic. The two studies were prospectively and independently interpreted for the presence and location of ureteral stones, abnormalities unrelated to stone disease, identification of secondary signs, i.e. hydronephrosis and perinephric stranding, and tissue rim sign. The standard-dose CT images were interpreted by one reviewer and the low-dose CT images independently by two reviewers unaware of the standard-dose CT findings. The findings of the standard and low-dose CT scans were compared with the exact McNemar test. Interobserver agreements were assessed with kappa analysis. The effective radiation doses resulting from two different protocols were calculated by means of commercially available software to which the Monte-Carlo phantom model was given. Results: The sensitivity, specificity, and accuracy of standard-dose CT for detecting ureteral stones were 99%, 93%, and 98%, respectively, whereas for the two reviewers the sensitivity of low-dose CT was 93% and 95%, specificity 86%, and accuracy 92% and 94%. We found no significant differences between standard-dose and low-dose CT in the sensitivity and specificity for diagnosing ureter stones ( P >0.05 for both). However, the sensitivity of low-dose CT for detection of 19 stones less than or equal to 2 mm in diameter was 79% and 68%, respectively, for the two reviewers. Low-dose CT was comparable to standard-dose CT in visualizing hydronephrosis and the tissue rim sign. Perinephric stranding was far less clear on low-dose CT. Low-dose CT had the same diagnostic performance as standard-dose CT in diagnosing alternative diseases. Interobserver agreement between the two low-dose CT reviewers in the diagnosis of

  6. Acute phase proteins as diagnostic markers in horses with colic

    Pihl, Tina Holberg; Scheepers, Elrien; Sanz, Macarena;

    2016-01-01

    Objective - To investigate the diagnostic potential of acute phase proteins (serum amyloid A (SAA), haptoglobin and fibrinogen) measured in blood and peritoneal fluid for differentiating horses with inflammatory colic (entero-colitis and peritonitis) from those with surgical colic. Design...... - Prospective observational multicenter study. Setting - Two university referral hospitals. Animals - Horses referred for severe acute abdominal pain to hospital 1 (n=148) or hospital 2 (n=78). Intervention - Blood and peritoneal fluid samples collected at admission were used for acute phase protein measurement...... significantly. When validated in hospital 2 data, the models had a satisfying integrity and diagnostic performance. Conclusions – Evaluation of SAA in serum improved the ability to differentiate horses with acute inflammatory colic requiring medical treatment from horses with colic requiring surgical treatment...

  7. Parenteral lidocaine for treatment of intractable renal colic: a case series

    Vaezi Hassan; Mohammadi Dawood; Hassanzadeh Kamaleddin; Soleimanpour Hassan; Esfanjani Robab

    2011-01-01

    Abstract Introduction We report a case series of successful treatment of intractable renal colic using parenteral lidocaine. Case presentation Because of inconsistent responses to standard treatment with opioids and non-steroidal anti-inflammatory drugs in patients with renal colic pain, we decided to begin a trial of a single intravenous dose of lidocaine (approximately 1.5 mg/kg) slowly in eight patients with intractable renal colic who were referred to our emergency medicine department. Th...

  8. Successful treatment of a persistent renal colic with trigger point injection.

    Eken, Cenker; Durmaz, Dilek; Erol, Bulent

    2009-02-01

    Renal colic is one of the painful conditions in emergency medicine practice. Opiates and nonsteroidal anti-inflammatory drugs are the cornerstone of pain management in renal colic. However, alternative procedures should be considered in patients refractory to conventional therapies. We present a case of renal colic successfully treated by trigger point injection that was refractory to 150 microg fentanyl and 5 mg morphine. PMID:19371551

  9. Survey on Acupuncture Treatment of Urinary Calculus and Renal Colic

    HUANG Qin-feng; XIAO Yuan-chun

    2003-01-01

    Analyzed 74 articles relevant to urinary calculus and renal colic. The statistics found that the commonly used therapies were needling, acupuncture and moxibustion, electro-acupuncture, acupoint-injection,ear-point application, ear acupuncture, wrist-ankle acupuncture, scalp acupuncture, acupressure and combined acupuncture methods. The common acupoints that were used over 1,400 times in more than 12 articles were Shenshu ( BL 23 ), Sanyinjiao ( SP 6), Zusanli ( ST 36),Zhongji (CV 3), and Jingmen (GB 25).

  10. A Fatal Diagnosis in Emergency Department: Renal Colic

    Küçük, Egemen

    2015-01-01

    Aortic dissection is a rare, fatal disease that can mimic some of the different diseases. More common seen in males and 50-70 years of age. Hypertension is the most important factor in the etiology. Usually, predatory, severe and sudden onset pain is described. Back and flank pain, can be seen depending on the malperfusion in distal dissections. This is similar to the pain of renal colic in character, is defined as serious, intermittent flank pain. Aortic dissection, located in the differenti...

  11. Analgesic Effects of Inhalation of Nitric Oxide (Entonox) and Parenteral Morphine Sulfate in Patients with Renal Colic; A Randomized Clinical Trial

    Hamid Kariman; Alireza Majidi; Sara Taheri; Ali Shahrami; Hamid Reza Hatamabadi

    2015-01-01

    Objective: To compare the analgesiceffects of Nitrous oxide and morphine sulfate in patients with acute renal colic due to urolithiasis. Methods: This was randomized clinical trial being performed in Imam Hossein hospital affiliated with Shahid Beheshti University of Medical Sciences during a 1-year period from May2013 to May2014. A total of number of 100 patients, with an age range of 20-50 years, who presented with renal colic secondary to urolithiasis confirmed by ultrasonography we...

  12. 氯诺昔康联合坦索罗辛治疗急性肾绞痛疗效分析%Clinical Effect of Lornoxicam Combined with Tamsulosin on Acute Renal Colic

    熊海云; 胡晖; 余明主; 谭公祥; 陈亚梅; 曾小明

    2012-01-01

    Objective To observe the clinical effect of lornoxicam combined with tamsulosin on acute renal colic. Methods Forty-six patients with acute renal colic were divided into two groups, with 23 patients in each group. The observation group was given intramuscular injection of 8 mg lornoxicam and oral administration of 0. 2 mg tamsulosin. The control group was given intramus-cular injection of 50 mg pethidine hydrochloride and 10 mg anisodamine. Analgesic effect,adverse events and pain recurrence were recorded in both groups. Results There were no significant differences in analgesic effect and incidence of gastrointestinal symptoms between the two groups (P -0. 35,P = 0. 208). Compared with control group, the incidences of neuropsychiatric events and other adverse reactions obviously decreased in observation group (P<0. 05). Recurrence rate of renal colic was 60. 9% (14 patients) in observation group and 91. 3% (21 patients) in control group,and the difference was significant between the two groups (P -0. 035). Conclusion The lornoxicam combined with tamsulosin was effective in the treatment of renal colic, with few ad-verse effects, low recurrence rate, safe re-use and non-addictive habit formation.%目的 观察氯诺昔康联合坦索罗辛治疗急性肾绞痛的临床疗效.方法 选择46例急性肾绞痛患者,按患者就诊时间顺序交替分成2组,每组23例.观察组给予注射用氯诺昔康8 mg肌内注射,坦索罗辛0.2 mg口服;对照组给予盐酸哌替啶50 mg、山莨菪碱(654-2)注射液10 mg肌内注射,分别观察镇痛效果、不良反应及24~48 h疼痛再发率.结果 观察组与对照组镇痛效果比较差异无统计学意义(P=0.35);消化道症状发生率2组比较差异无统计学意义(P=0.208),观察组神经精神及其他不良反应发生率明显低于对照组(均P<0.05);观察组肾绞痛再发14例(60.9%),对照组再发21例(91.3%),观察组肾绞痛再发率低于对照组(P=0.035).结论 氯诺昔康联合坦

  13. Is it renal colic or ruptured dissecting aneurysm of renal artery?: A case report

    Marwah, Sanjay; Singla, Sham; Kalra, Rajnish; Marwah, Nisha; Singh, Shashi Pratap

    2009-01-01

    Introduction The dissecting aneurysm of renal artery is a form of renal artery occlusive disease that is infrequently recognized in the literature. However, when encountered, it is of great clinical significance because symptoms related to aneurysm are rarely seen and there is risk of its rupture. Case Presentation The present case was a 30 year old Indian male, who presented with recurrent episodes of pain mimicking renal colic, which turned out to be a ruptured dissecting aneurysm of renal ...

  14. The effects of Ramadan fasting on the number of renal colic visits to the emergency department

    Cevik, Yunsur; Corbacioglu, Seref Kerem; Cikrikci, Gulsah; Oncul, Veysel; Emektar, Emine

    2016-01-01

    Objective: The effects of fluid and diet restriction strictly during the long hours in Ramadan on the number of colic visits and biochemical factors of stone formation are controversial in the literature. The aim of this study was to assess the effects of Ramadan fasting on the number of renal colic visits and laboratory results of patients with renal colic. Methods: This was a prospective observational study, which was conducted with patients who were admitted to our emergency department wit...

  15. Comparing the Efficacy and Adverse Effects of Tramadol and Sodum Diclofenac with pethedine in the Treatment of Renal Colic

    M Rajaei

    2013-04-01

    Full Text Available Abstract Background & aim: One of the choice treatments for pain relief in acute renal colic is administration of narcotics, but always the need for low-dose effects are felt difficulties. The aim of this study was to compare the efficacy of sodium diclofenac and pethedine hydrochloride with Tramadol to reduce the pain of acute renal colic. Methods: In this clinical trial study, 150 patients (15-65 years with acute renal colic referred to Kashani hospital in Shahrekord were selected. The patients were randomly divided into 3 groups. The first group received 50mg tramadol intramuscular, the second group received 75mg D sodum iclofenac intramuscular and the third group (the evidence group received 50 mg pethidin intramuscular. The pain severity was assessed before and then at 15, 30,60minutes after drug administration based on the McGill questionnaire. Data were analyzed with chi-square tests, ANOVA and Kruskal-Wallis tests. The pain severity of all parties on arrival to emergency ward and prior to the drug administration, and then 15, 30 and 60 min after the start of treatment were measured using a modified McGill questionnaire. Results: After drug administration (30.15 and 60 min, pain severity were decreased in all three groups. Minimum pain was seen in control where as the maximum pain was seen in tramadol group. Diclofenac have less side effects than pethedine (P<0.05. Conclusion: The finding showed that intramuscular Na Diclofenac due to its less adverse effects and more efficacy than tramadol is a suitable alternative to pethedine in treatment of acute renal colic. Key words: Pethedine, Tramadol, Diclofenac Na, Renal Colic

  16. Do the patients with acute calculous renal colic need administration of antibiotics%急性结石性肾绞痛发作时合并尿路感染及使用抗生素效果研究

    武卫; 吴海斌

    2014-01-01

    Objective To explore the possibility of acute calculous renal colic complicated with urinary tract infection and the necessity of antibiotics administration. Methods Total 290 patients with acute calculous renal colic were randomly assigned into study and control groups. The spasmolytic (phloroglucinal) and analgesia(ketorolac tromethamine) were given to both groups and antibiotics(levofloxacin lactate) were additional y administrated in study group. The temperature and blood WBC counts were measured;the midstream urine specimens were analyzed with Symex UF- 1000i, and the urinary WBC, nitrite and bacterial count were used as indexes for urinary tract infection. Results Only 10.0%and 20.7% patients had fever and increased blood WBC count. There were 95 (32.6%) cases had positive indexes of urinary tract infection. The rates of pain relief were 95.8%and 94.6%in study and control groups, respectively (P>0.05). The rate of relapse in study and control groups was 25.6%and 28.4%, re-spectively (P>0.05). Conclusion The complication of acute renal calculous colic with urinary infection is less common, and an-tibiotics should be used only in patients with definite indexes of infection.%目的:探讨急性结石性肾绞痛发作时合并尿路感染的可能和使用抗生素的依据,避免滥用抗生素。方法将290例急性结石性肾绞痛患者随机分为两组:观察组143例在使用解痉药物(间苯三酚)和止痛药物(酮咯酸氨丁三醇)的同时加用抗生素(左氧氟沙星);对照组147例仅使用解痉和止痛药物。使用UF-1000i尿全自动分析仪检测两组患者中段尿WBC、细菌数和亚硝酸盐,并测体温和血WBC。统计并比较两组有发热、血WBC增高和中段尿检测尿路感染指标阳性患者的比例、治疗有效率和72h内肾绞痛再发率。结果290例患者中,有发热和血WBC增高者各占10.0%和20.7%;中段尿检测中尿路感染指标为阳性的患者占32.6%;观

  17. Study on the Acute Renal Colic Treated with Celebrex and Progesterone%塞来昔布联合黄体酮对急性肾绞痛的观察

    陈方慧; 肖晨; 周悦婷; 许国根

    2011-01-01

    目的 探讨选择性COX -2抑制剂塞来昔布(西乐葆)加黄体酮对急性肾绞痛的疗效.方法 采用单盲法随机给急性肾绞痛病人分成两组:观察组(n=60)以黄体酮40mg加西乐葆400mg治疗急性绞痛.对照组(n=57)以哌替啶100mg加654 -220mg治疗绞痛.分别以15min,30min,1h,2h,观察疼痛缓解度;两组药物不良反应发生率.用药2天后血尿改变情况,采用软件SPSS 10.0统计进行方差分析.结果 两组患者在2h内疼痛缓解无统计学差异(P>0.05),而不良反应与血尿缓解情况有明显统计学意义(P<0.05);观察组优于对照组.结论 对于急性肾绞痛,以黄体酮联合西乐葆治疗与以哌替啶治疗效果相当,而不良反应发生率低,结石下行时间缩短,并减少结石对输尿管壁的损伤.%Objective To explore the curative effect of Celebrex and progesterone for acute renal colic. Methods The cases of a-cute renal colic were divided into two groups with single blind randomization. The cases in observation group (n = 60) were treated with Celebrex 400mg and progesterone 40mg. Cases in control group(n = 57) were treated with pethidine 100mg and 654 -2 20mg. Then the curative effect and side reaction after 15min,30min,lh,2h were observed. Meanwhile the hematuria of cases was examined in 2 days. The results were analyzed by variance (ANOVA) with SPSS 10.0. Results The odynolysis between two groups had no significant difference ( P > 0. 05 ) , but the difference in side reaction and hematuria was significant (P < 0. 05 ) . The therapy effect of observation group was su-pior to the control group. Conclusion For acute renal colic,Celebrex and progesterone or pethidine has the same curative effect,but the former has more advantages,such as less side effectless dropping time of calculus,and less injure ureter.

  18. Anxiety and depression symptoms in recurrent painful renal lithiasis colic

    D.H.M.P. Diniz

    2007-07-01

    Full Text Available Several studies have reported that symptoms of anxiety and depression are significantly associated with diseases characterized by painful crises. However, there is little information about the psychological aspects of recurrent painful episodes of renal stone disease. Our objective was to evaluate the association of symptoms of anxiety, depression and recurrent painful renal colic in a case-control study involving 64 subjects (32 cases/32 controls matched for age and sex. Cases were outpatients with a confirmed diagnosis of nephrolithiasis as per their case history, physical examination, image examination and other laboratory exams. Patients had a history of at least two episodes within a 3-year period, and were currently in an intercrisis interval. The control group consisted of subjects seen at the Ophthalmology Outpatient Clinic of this University Hospital with only eye refraction symptoms, and no other associated disease. Symptoms of anxiety were evaluated by the State-Trait Anxiety Inventory and symptoms of depression by the Beck Depression Inventory. Statistically significant differences were observed between patients with nephrolithiasis and controls for anxiety state (P = 0.001, anxiety trait (P = 0.005 and symptoms of depression (odds ratio = 3.74; 95%CI = 1.31-10.62. The Beck Depression Inventory showed 34.5% of respondents with moderate and 6% with severe levels of depression. There was a significant linear correlation between symptoms of anxiety (P = 0.002 and depression (P < 0.001 and the number of recurrent colic episodes (anxiety-state: P = 0.016 and anxiety-trait: P < 0.001. These data suggest an association between recurrent renal colic and symptoms of both anxiety and depression.

  19. Renal colic, where is it headed? An observational study

    Paolo Beltrami

    2016-03-01

    Full Text Available Aim: In the last thirty years, the treatment for renal and ureteral calculi has undergone profound variations. The objective of this study has been to evaluate the existence of parameters which can affect the spontaneous expulsion of a symptomatic ureteral stone in a reasonably brief period of time and to identify whether certain parameters such as sex, age, the location and dimension of the stone, the presence of dilation in the urinary tract together with the administered therapy, can be used for a correct clinical management of the patient. Methods: In a period of 9 months, 486 cases of renal colic were registered at emergency department. Results: The cases of renal colic due to ureteral calculus were 188 (38.7%. The patients’ charts, complete of all data and therefore, valid for this research, resulted to be 120 (64%. In the presence of a symptomatic ureteral stone, the correct approach must first of all, focalize on the dimension of the calculus itself; less importance instead, is given to the location, as reported in other studies, the presence of hydroureteronephrosis, sex and the side. Conclusion: In the cases when the pain symptoms cannot be solved by means of the administration of analgesics, it is then reasonable to take into consideration an immediate endourological treatment. If the pain symptoms are promptly solved, an attentive wait of 4 weeks should be considered reasonable in order to allow spontaneous expulsion of the calculus.

  20. Present-day imaging of patients with renal colic

    Dalla Palma, L.; Pozzi-Mucelli, R.; Stacul, F. [Trieste Univ. (Italy). Dept. of Radiology

    2001-01-01

    In the past decade alternatives to urography have been proposed for the study of patients with renal colic. In 1992 it was suggested to replace urography with KUB and ultrasonography. In 1993 the combination of KUB and ultrasonography followed by urography in unresolved cases was proposed and, in 1995, it was suggested to replace urography with unenhanced helical CT (UHCT). This article illustrates the contribution of UHCT to the study of patients with renal colic and analyses advantages and shortcomings of the technique compared with other diagnostic approaches. Diagnostics of the patient with renal colic is based on the detection of direct and indirect signs which allow identification of not only the calculus, with a sensitivity of 94-100% and accuracy of 93-98% according different authors, but also other signs that can serve to guide patient management and evaluate long-term prognosis. Unenhanced helical CT has the capability to detect extraurinary abnormalities which present with flank pain and mimic renal colic. The examination technique affects the quality of the images and therefore diagnostic accuracy as well as the dose to the patient. With regard to setting parameters, the choice of thickness and table feed should be guided by numerous factors. Multiplanar reconstruction is indicated in the study of the entire ureter course to identify the exact site of the calcification for the urologist to perform an evaluation similar to that obtained by urography. Many authors consider UHCT to be a valuable tool for suggesting the best therapeutic approach. Among these there are also urologists. The evaluation is based on the stone detection, its size and level in the urinary tract. Cost analysis shows that the cost of UHCT is equal to or inferior to the cost of urography. With regard to the dose, different data are reported in the literature. A high pitch (more than 1.5) and a thin collimation (3-mm thickness) are good compromise between quality and dose which can be

  1. Toradol, an NSAID used for renal colic, decreases renal perfusion and ureteral pressure in a canine model of unilateral ureteral obstruction.

    Perlmutter, A; Miller, L; Trimble, L A; Marion, D N; Vaughan, E D; Felsen, D

    1993-04-01

    Toradol is a new parenteral, nonsteroidal anti-inflammatory drug which is efficacious in treating renal coli. In the present experiments, Toradol was administered to both control dogs and dogs with unilateral ureteral obstruction. In control dogs, Toradol had no effect on RBF or GFR, despite inhibition of renal prostaglandin synthesis (measured as urinary prostaglandin release). In contrast, RBF fell acutely by 35% (p renal hemodynamics brought on by Toradol to the obstructed kidney may compromise renal reserve, and Toradol should be used cautiously in treating renal colic. PMID:8455277

  2. The Role of Non-Steroidal Anti-Inflammatory Drugs in Renal Colic

    Elizabeth Waine

    2010-04-01

    Full Text Available NSAIDs provide optimal analgesia in renal colic due to the reduction in glomerular filtration and renal pelvic pressure, ureteric peristalsis and ureteric oedema. Prevention of glomerular afferent arteriolar vasodilatation renders these patients at risk of renal impairment. NSAIDs have the additional benefit of reducing the number of new colic episodes and preventing subsequent readmission to hospital. Despite recent work promoting the use of pharmacological agents to improve stone passage rates, NSAIDs do not appear to reduce the time to stone passage or increase the likelihood of stone passage in renal colic.

  3. Treatment of renal colic by prostaglandin synthetase inhibitors and avafortan (analgesic antispasmodic).

    el-Sherif, A E; Foda, R; Norlen, L J; Yahia, H

    1990-12-01

    In a study of the pain-relieving effect of 3 drugs commonly used to treat acute renal colic in this hospital, intravenous indomethacin and intramuscular diclofenac (prostaglandin synthetase inhibitors) were compared with intravenous Avafortan (analgesic antispasmodic). As first-line analgesics, prostaglandin synthetase inhibitors, if given intravenously, offer an effective alternative to Avafortan. Of 145 patients studied, 32 required a second injection for complete relief of pain. Administering a second dose of prostaglandin synthetase inhibitors resulted in equally significant pain relief rate even though the route was intramuscular. PMID:2265331

  4. Intravenous indoprofen in the management of renal colic.

    Torchi, B; Villani, U; Bruni, G; Lavezzari, M; Mandelli, V

    1983-01-01

    Recent reports imply that the prostaglandin system is involved in the pathogenesis of pain due to renal colic, and prostaglandin-synthetase inhibitors have been proposed in the management of this condition. A dose-response study has therefore been performed in patients with renal colic, using two intravenous non-steroidal antiinflammatory drugs, indoprofen and lysine acetylsalicylate (ASA). Seventy-five inpatients (15 per group) were treated with three dose levels of indoprofen (100, 200 and 400 mg) or two dose levels of ASA (500 and 1500 mg) according to a double-blind, randomized, parallel-group design. The patients scored their pain at 15, 30, 60, 120 and 180 minutes after treatment; they also assessed the overall efficacy of treatment by means of a visual analogue scale. The results showed that, in terms of mean pain score, there was a prompt analgesic response in each treatment group, higher effects being obtained with increasing dose levels of both drugs. However, the statistical prerequisites for calculating a potency ratio between the drugs under study were satisfied only for a few variables, in which cases the relative potency of indoprofen to ASA varied between 7.1 and 8.8. The analysis of the frequencies of response, on the other hand, revealed for indoprofen a significant dose-effect regression, the higher dose of this drug giving a complete or nearly complete relief of pain in the majority of patients. PMID:6384073

  5. Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

    Mahmoud Abdel-Gawad

    2014-08-01

    Full Text Available Purpose Despite the routine use of helical CT in diagnosis of renal colic, there are recent concerns regarding the radiation exposure, overuse and costs. We attempted in this retrospective study to evaluate the accuracy of ultrasound (gray-scale and color Doppler with twinkling, KUB and urinalysis in diagnosis of renal colic due to ureteral calculi presented in Emergency Room. Materials and Methods A total of 939 consecutive cases of renal colic presented to ER have been managed and evaluated by ureteral ultrasound, KUB and urinalysis for the presence of ureteral stones. Non-confirmatory cases were subjected to Helical CT examination. Results Renal and ureteral ultrasound (gray-scale alone detected ureteral calculi in 615 cases (65.4% and after utilizing Color Doppler Ultrasound with twinkling the diagnosis was made with confidence in 935 cases (99.6% but 4 (0.4%. KUB showed radiopaque stones in 503 (53.6% patients and no stones were detected in 436 (46.4%. Microhematuria presented in 835 (88.9% cases while absent in 102 (10.9%. There were 190 (20.3%, 77 (8.2% and 671 (71.5% patients with upper, middle and lower ureteral stones respectively. The simultaneous positive findings in US and KUB with microhematuria were found only in 453 (48.2% cases. Conclusions The use of Color Doppler ultrasound with twinkling increased the detection rate of ureteral stones in acute renal colic patients presented to ER with less radiation exposure. Ultrasound examination as a single modality is superior to KUB and urinalysis in initial diagnosis of renal colic.

  6. The Role of Non-Steroidal Anti-Inflammatory Drugs in Renal Colic

    Elizabeth Waine; Kim Davenport

    2010-01-01

    NSAIDs provide optimal analgesia in renal colic due to the reduction in glomerular filtration and renal pelvic pressure, ureteric peristalsis and ureteric oedema. Prevention of glomerular afferent arteriolar vasodilatation renders these patients at risk of renal impairment. NSAIDs have the additional benefit of reducing the number of new colic episodes and preventing subsequent readmission to hospital. Despite recent work promoting the use of pharmacological agents to improve stone passage ra...

  7. The Effect of Intramuscular Tramadol Hydrochloride Combined with Progesterone on Acute Renal Colic%盐酸曲马多联合黄体酮治疗急性肾绞痛效果研究

    罗正菊

    2015-01-01

    Objective:To explore the effect of intramuscular tramadol hydrochloride combined with pro-gesterone on acute renal colic .Method:86 cases of acute renal colic were randomly divided into observation group (44 cases) and control group(42 cases).The observation group was given 100mg tramadol intravenous drip combined with 40mg progesterone, the control group was given 100mg meperidine hydrochloride injec-tion with 0.5mg atropine sulfate.Visual analog scale(VAS)was used to record patients pain degree and ana-lyze the onset time and adverse effects before and after drug delivery 15min, 30min, 1h, 4h respectively. Result:There were no significant differences on effective rate and drug onset time between the two groups ( P>0.05) .The VAS scores of observation group after drug delivery from 15min to 4 hours were lower than the control group(P<0.05), rates of adverse drug reactions such as dizziness , xerostomia, uroschesis in observa-tion group were lower than control group (P<0.05).Meanwhile, progesterone intramuscular injection were given to observe group with 30mg/QD in three days, Kidney stones were excluded of 12 cases which showed significant difference with the control group .Conclusion: Intramuscular tramadol hydrochloride combined with progesterone on acute renal colic shows significant effect , which would be used as the emergency medi-cine on acute renal colic .%目的:观察肌肉注射盐酸曲马多联合肌肉注射黄体酮治疗急性肾绞痛的临床效果。方法:86例确诊为急性肾绞痛患者随机分为观察组和对照组,观察组(44例)给予肌肉注射盐酸曲马多100mg同时肌肉注射黄体酮40mg,对照组(42例)给予肌肉注射盐酸哌替啶100mg及硫酸阿托品0.5mg。给药前、后15min、30min、1h、4h对患者疼痛采用视觉模拟评分( VAS)评价其疗效,并观察其起效时间和不良反应。结果:观察组止痛总有效率为90.91%,对照组总有效率为90.48%,两组

  8. Renal colic: a randomised trial of non-enhanced spiral CT compared to intravenous pyelography

    Full text: Many studies have demonstrated high accuracy of non-enhanced spiral CT (NECT) in renal colic, with sensitivities and specificities of 95-100%. There have been few studies comparing the diagnostic utility and outcomes of patients investigated with NECT and intravenous pyelography (IVP). Two hundred patients presenting to the Emergency Department of a tertiary public teaching hospital with suspected acute renal colic were randomised into undergoing NECT or IVP. Assessments were made of diagnostic utility, incidence of alternative diagnosis, requirement for further imaging, length of hospital stay, urological intervention rates, radiation dosage and costs. NECT was better than IVP in making a definitive diagnosis of ureteric calculus or of recent calculus passage (65/102, 66% versus 42/98, 41%). Calculi were missed in 2 patients in the IVP group.Two patients in each group had alternative diagnosis by initial imaging. There was no difference in the length of hospital stay or intervention rate. More plain x-rays during admission and more IVPs during follow-up were performed in the NECT group. Median effective radiation dosages were 2.97mSv (IVP) and up to 5mSv (NECT). NECT provides greater diagnostic utility in this randomised comparison, but no difference in measured outcomes. The incidence of alternative diagnoses was low, probably due to patient selection. Financial costs for each modality are comparable in a public tertiary hospital. Radiation dosages are higher for NECT and, for this reason it may be appropriate to consider limiting NECT use to patients who do not have classical symptoms of renal colic, to older patients and those with a contraindication to the administration of intravenous contrast media. Copyright (2002) Blackwell Science Pty Ltd

  9. Synergistic Effects of Citalopram and Morphine in the Renal Colic Pain Relief; a Randomized Clinical Trial

    Mehrdad Esmailian

    2014-03-01

    Full Text Available Introduction: Although the synergistic effects of opioids and other analgesic drugs such as non-steroidal anti-inflammatory drugs (NSAIDs have been established in relieving acute pain due to renal calculi, no studies today have evaluated the concomitant administration of opiates and other drugs with analgesic effects, such as serotonin re-uptake inhibitors. Considering the high prevalence of renal colic, the present study was carried out to compare the effect of concomitant prescription of morphine and a placebo with that of morphine and citalopram on the management of acute pain due to renal calculi. Methods: The present double-blind randomized clinical trial was carried out from October 2012 to March 2013 in the Al-Zahra educational Hospital in Isfahan, Iran. A total of 90 patients with acute renal colic pain were randomly divided into two groups of 45 subjects. The subjects in one group received morphine/ placebo and another one morphine/citalopram. The patients’ pain severity was determined by visual analogue scale (VAS before and 20 minutes after administration of medications. In case of persistent pain the second or even third dose was administered and the pain severity was once again determined. Data were analyzed with STATA 11.0 using chi-squared, two-way ANOVA, Bonferroni post hoc test, and log rank test. Results: The decrease in pain severity in the morphine/citalopram group was significantly compared to the morphine/placebo group and the time before administration of the medications (p<0.001. In contrast, administration of morphine/placebo did not have a significant effect on pain severity at this interval (p=0.32. Kaplan-Meier curve showed that the first injection was successful in relieving pain in 15 (33.3% and 26 (57.8% subjects in the morphine/placebo and morphine/citalopram groups, respectively. The second injection of these medications resulted in therapeutic success in 35 (87.8% and 42 (95.6% subjects in the above groups

  10. Application of Ureteroscope in Emergency Treatment with Persistent Renal Colic Patients during Pregnancy

    Zhang, Shilin; Liu, Guoqing; Duo, Yongfu; Wang, Jianfeng; Li, Jierong; Li, Chunjing

    2016-01-01

    Background Although the application of ureteroscopy in the treatment of ureteral calculi during pregnancy has been on the rise, for persistent renal colic patients without ultrasound-detected ureteral calculi, it may represent a clinical dilemma due to the potential risks for both mother and fetus. Objective The aim of the present study is to present our experience with the application of the ureteroscope in the emergency treatment of persistent renal colic patients during pregnancy. Methods ...

  11. Raised white cell count in renal colic: Is there a role for antibiotics?

    Adam Alleemudder

    2014-01-01

    Conclusions: Over three-quarters of the patients (80.9% in this study who presented with renal colic were unjustifiably commenced on antibiotics based solely on an elevated WCC. Antibiotic use in renal colic should be reserved for when there are features of sepsis or the urinalysis is positive. Further work is required to determine the significance of the observed results and the threshold for starting antibiotics.

  12. Raised white cell count in renal colic: Is there a role for antibiotics?

    Adam Alleemudder; Xin-You Tai; Anuj Goyal; Jhumur Pati

    2014-01-01

    Aims: To determine the use of antibiotics in patients with renal colic and an elevated white cell count (WCC) in the absence of other features of infection. Materials and Methods: A retrospective audit of patients presenting to an emergency department with renal colic caused by a solitary ureteric stone over a 6 month period. Statistical Analysis Used: Student′s t-test. Results: Fifty patients met the inclusion criteria for this study. In 42 patients (84%) the urinalysis showed he...

  13. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department

    Soleimanpour Hassan; Hassanzadeh Kamaleddin; Vaezi Hassan; EJ Golzari Samad; Esfanjani Robab; Soleimanpour Maryam

    2012-01-01

    Abstract Background Despite the fact that numerous medications have been introduced to treat renal colic, none has been proven to relieve the pain rapidly and thoroughly. In this study, we aimed at comparing the effects of intravenous lidocaine versus intravenous morphine in patients suffering from renal colic. Methods In a prospective randomized double-blind clinical trial performed in the emergency department of Imam Reza educational hospital of Tabriz, Iran, we studied 240 patients, 18–65 ...

  14. Daily ambient temperature and renal colic incidence in Guangzhou, China: a time-series analysis

    Yang, Changyuan; Chen, Xinyu; Chen, Renjie; Cai, Jing; Meng, Xia; Wan, Yue; Kan, Haidong

    2016-08-01

    Few previous studies have examined the association between temperature and renal colic in developing regions, especially in China, the largest developing country in the world. We collected daily emergency ambulance dispatches (EADs) for renal colic from Guangzhou Emergency Center from 1 January 2008 to 31 December 2012. We used a distributed-lag nonlinear model in addition to the over-dispersed generalized additive model to investigate the association between daily ambient temperature and renal colic incidence after controlling for seasonality, humidity, public holidays, and day of the week. We identified 3158 EADs for renal colic during the study period. This exposure-response curve was almost flat when the temperature was low and moderate and elevated when the temperature increased over 21 °C. For heat-related effects, the significant risk occurred on the concurrent day and diminished until lag day 7. The cumulative relative risk of hot temperatures (90th percentile) and extremely hot temperatures (99th percentile) over lag days 0-7 was 1.92 (95 % confidence interval, 1.21, 3.05) and 2.45 (95 % confidence interval, 1.50, 3.99) compared with the reference temperature of 21 °C. This time-series analysis in Guangzhou, China, suggested a nonlinear and lagged association between high outdoor temperatures and daily EADs for renal colic. Our findings might have important public health significance to prevent renal colic.

  15. Daily ambient temperature and renal colic incidence in Guangzhou, China: a time-series analysis

    Yang, Changyuan; Chen, Xinyu; Chen, Renjie; Cai, Jing; Meng, Xia; Wan, Yue; Kan, Haidong

    2015-11-01

    Few previous studies have examined the association between temperature and renal colic in developing regions, especially in China, the largest developing country in the world. We collected daily emergency ambulance dispatches (EADs) for renal colic from Guangzhou Emergency Center from 1 January 2008 to 31 December 2012. We used a distributed-lag nonlinear model in addition to the over-dispersed generalized additive model to investigate the association between daily ambient temperature and renal colic incidence after controlling for seasonality, humidity, public holidays, and day of the week. We identified 3158 EADs for renal colic during the study period. This exposure-response curve was almost flat when the temperature was low and moderate and elevated when the temperature increased over 21 °C. For heat-related effects, the significant risk occurred on the concurrent day and diminished until lag day 7. The cumulative relative risk of hot temperatures (90th percentile) and extremely hot temperatures (99th percentile) over lag days 0-7 was 1.92 (95 % confidence interval, 1.21, 3.05) and 2.45 (95 % confidence interval, 1.50, 3.99) compared with the reference temperature of 21 °C. This time-series analysis in Guangzhou, China, suggested a nonlinear and lagged association between high outdoor temperatures and daily EADs for renal colic. Our findings might have important public health significance to prevent renal colic.

  16. Morphine Suppository versus Indomethacin Suppository in the Management of Renal Colic: Randomized Clinical Trial.

    Zamanian, Forough; Jalili, Mohammad; Moradi-Lakeh, Maziar; Kia, Maryam; Aghili, Rokhsareh; Aghili, Seyed Mojtaba

    2016-01-01

    Background. Renal colic is a medical emergency due to the rapid onset and devastating nature of its pain. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are both used as first-line choices in its management. Aim. This study aimed to compare the efficacy and safety of opioids and NSAIDs in the management of acute renal colic. Methods. One hundred and fifty-eight patients were divided into two groups (n = 79) and received either 10 mg morphine or 100 mg indomethacin suppositories. The severity of pain was measured using verbal numeric rating scale at baseline and 20, 40, 60, and 90 minutes after the administration of analgesics. Drug side effects as well as patients' vital signs were also recorded. Results. The mean decrease in the pain score during the first 20 minutes was significantly higher among those who received morphine suppository. However, no significant difference was observed between the two groups regarding the mean decrease in pain score during the first 40, 60, and 90 minutes after the admission. Prevalence of drug side effects or changes in the vital signs was not significantly different between the two groups. Conclusions. Morphine suppositories seem to be more efficient in achieving rapid pain relief comparing to indomethacin. PMID:27073696

  17. Morphine Suppository versus Indomethacin Suppository in the Management of Renal Colic: Randomized Clinical Trial

    Forough Zamanian

    2016-01-01

    Full Text Available Background. Renal colic is a medical emergency due to the rapid onset and devastating nature of its pain. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs are both used as first-line choices in its management. Aim. This study aimed to compare the efficacy and safety of opioids and NSAIDs in the management of acute renal colic. Methods. One hundred and fifty-eight patients were divided into two groups (n=79 and received either 10 mg morphine or 100 mg indomethacin suppositories. The severity of pain was measured using verbal numeric rating scale at baseline and 20, 40, 60, and 90 minutes after the administration of analgesics. Drug side effects as well as patients’ vital signs were also recorded. Results. The mean decrease in the pain score during the first 20 minutes was significantly higher among those who received morphine suppository. However, no significant difference was observed between the two groups regarding the mean decrease in pain score during the first 40, 60, and 90 minutes after the admission. Prevalence of drug side effects or changes in the vital signs was not significantly different between the two groups. Conclusions. Morphine suppositories seem to be more efficient in achieving rapid pain relief comparing to indomethacin.

  18. Morphine Suppository versus Indomethacin Suppository in the Management of Renal Colic: Randomized Clinical Trial

    Zamanian, Forough; Jalili, Mohammad; Moradi-Lakeh, Maziar; Kia, Maryam; Aghili, Rokhsareh; Aghili, Seyed Mojtaba

    2016-01-01

    Background. Renal colic is a medical emergency due to the rapid onset and devastating nature of its pain. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are both used as first-line choices in its management. Aim. This study aimed to compare the efficacy and safety of opioids and NSAIDs in the management of acute renal colic. Methods. One hundred and fifty-eight patients were divided into two groups (n = 79) and received either 10 mg morphine or 100 mg indomethacin suppositories. The severity of pain was measured using verbal numeric rating scale at baseline and 20, 40, 60, and 90 minutes after the administration of analgesics. Drug side effects as well as patients' vital signs were also recorded. Results. The mean decrease in the pain score during the first 20 minutes was significantly higher among those who received morphine suppository. However, no significant difference was observed between the two groups regarding the mean decrease in pain score during the first 40, 60, and 90 minutes after the admission. Prevalence of drug side effects or changes in the vital signs was not significantly different between the two groups. Conclusions. Morphine suppositories seem to be more efficient in achieving rapid pain relief comparing to indomethacin. PMID:27073696

  19. A rare cause of renal colic pain: Chilaiditi syndrome

    Murat Tuncer

    2014-09-01

    Full Text Available Chilaiditi syndrome, first described in 1910 by the radiologist Chilaiditi from Vienna, is the interposition of right colon between liver and right hemi diaphragm. It occurs most often in males and its incidence increases with age. It is often detected incidentally during radiological examination. It’s rarely symptomatic; symptoms can differ from mild abdominal pain to severe acute intestinal obstruction. Our case applied to emergency service with right flank pain. There was no calculus or dilatation in the urinary system at non-contrast abdominopelvic computerized tomography. Ascending colon was interposed between liver and diaphragm so that the patient was diagnosed as Chiliaditi syndrome. The patient was treated conservatively and discharged with dietary suggestions by the gastroenterology consultant. The conclusion of this report is that the Chilaiditi syndrome must be considered in differential diagnosis for patients presenting with urinary colic pain symptoms with no urinary pathology on radiologic imaging.

  20. Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

    Mahmoud Abdel-Gawad; Ravi Kadasne; Chandrashekar Anjikar; Emad Elsobky

    2014-01-01

    Purpose Despite the routine use of helical CT in diagnosis of renal colic, there are recent concerns regarding the radiation exposure, overuse and costs. We attempted in this retrospective study to evaluate the accuracy of ultrasound (gray-scale and color Doppler with twinkling), KUB and urinalysis in diagnosis of renal colic due to ureteral calculi presented in Emergency Room. Materials and Methods A total of 939 consecutive cases of renal colic presented to ER have been managed and eval...

  1. 酮咯酸丁三醇联合东莨菪碱治疗急性结石性肾绞痛的效果评估%Evaluation the efficacy of ketorolac butyl alcohol three combined with scopolamine in the treatment of acute renal colic

    阙永康

    2015-01-01

    目的:探讨酮咯酸丁三醇联合东莨菪碱治疗急性结石性肾绞痛的效果.方法:收治急性结石性肾绞痛患者280例,将其随机分为观察组(150例)和对照组(130例),所有患者均给予输液、东莨菪碱肌内注射,观察组肌注酮咯酸氨丁三醇,对照组肌注哌替啶.结果:观察组显效118例,有效17例,无效15例,24 h复发率4.67%.对照组显效95例,有效25例,无效10例.复发率3.85%.结论:酮咯酸丁三醇联合东莨菪碱治疗急性肾绞痛,疗效好,且不受麻醉药品限制,临床给药方便,是治疗急性结石性肾绞痛的有效选择.%Objective:To investigate the effect of ketorolac butyl alcohol three combined with scopolamine in the treatment of acute renal colic.Methods:280 patients whom suffered from acute renal colic were selected,they were randomly divided into the observation group(150 cases) and the control group(130 cases),all the patients were given infusion,injection with scopolamine intramuscular,in addations,patients in the observation group received intramuscular ketorolac tromethamine,while in the control group were given pethidine through intramuscular injection.Results:In the observation group,there 118 cases were markedly effective,17 cases were effective,and 15 cases were invalid,the recurrence rate during 24 hours was 4.67%.In the control group:there 95 cases were markedly effective,25 cases were effective,and other 10 cases were ineffective,the recurrence rate was 3.85%. Conclusion:Ketorolac butyl alcohol three combined with scopolamine has good curative effect in the treatment of acute renal colic, and also unlimited by anesthesia,convenient for clinical administration,so it is a valid option for treatment of acute renal colic.

  2. 推按运经仪治疗肾绞痛疗效观察%Observation of curative effects of Tui'anyunjingyi machine on renal colic

    于平; 腾伟; 王幼红; 刘艳丽

    2001-01-01

    @@ Background: Ureteral calculus is common causes of renal colic; patients usually go to hospital because of severe renal colic. We treated these patients with homemade Tui'anyunjingyi machine and gained good effects.

  3. Endovascular embolization of pseudoaneurysm of left colic artery developing after renal biopsy

    Madhusudhan, K. S.; Gamanagatti, S.; Gupta, A K

    2015-01-01

    Vascular complications after percutaneous renal biopsy are uncommon and may require interventional management. In most of these cases, the pathology is a renal arterial pseudoaneurysm (PsA) or an arterio-venous fistula. Injury to other vessels like aorta, lumbar arteries or mesenteric arteries is rare with only one case of left colic artery PsA reported in literature. We report a case of a 60-year-old female, who developed left colic artery PsA after renal biopsy, which was successfully embol...

  4. Recurrent acute renal failure

    Satish, S.; Rajesh, R.; Kurian, G.; Seethalekshmi, N. V.; Unni, M.; Unni, V. N.

    2010-01-01

    While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

  5. Value of ureteroscopic holmium laser lithotripsy for acute renal colic caused by middle or low ureteral stones%输尿管中下段结石肾绞痛时输尿管镜钬激光碎石治疗的价值

    王鑫洪; 林考兴

    2012-01-01

    目的 探讨输尿管镜下钬激光碎石术治疗输尿管中下段结石致急性肾绞痛患者的有效性和安全性.方法 对61例输尿管中下段结石伴肾绞痛患者行输尿管镜钬激光碎石治疗.结果 单次碎石成功率为100%.未出现输尿管黏膜损伤穿孔、撕裂、断裂、菌血症等严重并发症.术后随访2个月,结石排净率为100%.结论 输尿管镜钬激光碎石术治疗输尿管中下段结石安全、有效,能迅速缓解肾绞痛症状,可作为首选治疗方法之一.%Objective To observe the efficacy and safety of ureteroscopic holmium laser lithotripsy for acute renal colic caused by middle or low ureteral stones. Methods Sixty-one patients suffered with renal colic due to middle or low ureteral stones were treated with ureteroscopic holmium laster lithotripsy. Results The lithotripsy successful rate in a single procedure was 100% and there were no serious complications such as ureteral perforation, tear, breakage and bacteremia. After 2 months of follow up, the stone clearance rate was 100% . Conclusion Treatment of middle or low ureteral stones with ureteroscopic holmium laser lithotripsy is an effective and safe method. It could relieve the renal colic rapidly and be the optimal treatment for the disease.

  6. Analysis of the Effect of Diclofenac Sodium and Lidocaine Hydrochloride Injection in the Treatment of Acute Renal Colic%双氯芬酸钠盐酸利多卡因注射液治疗急性肾绞痛的疗效观察

    李淑晖

    2014-01-01

    Objective To evaluate the ef icacy Diclofenac Sodium and Lidocaine Hydrochloride Injection in the treatment of acute renal colic. Methods Isolated for simple renal sinus separation or with ureteral calculi with renal sinus in the ultrasonic diagnosis of 209 cases of acute renal colic patients, randomized way of clinical observation. The treatment group of 105 cases Diclofenac Sodium and Lidocaine Hydrochloride Injection treatment, control use of pethidine injection in the treatment of 104 cases in the treatment group, respectively30,60,120 minutes up to observe the clinical symptoms and signs, evaluation. Results Diclofenac Sodium and Lidocaine Hydrochloride Injection total ef ective rate in treatment group was 98.1%, higher than that of pethidine injection group, the total efficiency of 95.19%, by χ² test, <0.05, with statistical significance. Conclusion Diclofenac Sodium and Lidocaine Hydrochloride Injection good ef ect of the treatment of acute renal colic.%目的探讨双氯芬酸钠盐酸利多卡因注射液治疗急性肾绞痛的疗效。方法在超声诊断为单纯性肾窦分离或伴有输尿管结石的肾窦分离的209例急性肾绞痛患者中,采取随机分组方式进行临床治疗观察。治疗组105例用双氯芬酸钠盐酸利多卡因注射液治疗,对照组104例用哌替啶注射液治疗,分别在治疗30、60、120min复诊观察临床症状和体征,进行评定。结果双氯芬酸钠利多卡因注射液治疗组的总有效率为98.1%,高于哌替啶注射液组的总有效率95.19%,经χ²检验,P<0.05,具有统计学意义。结论双氯芬酸钠盐酸利多卡因注射液治疗急性肾绞痛效果良好。

  7. How to perform low-dose computed tomography for renal colic in clinical practice.

    Gervaise, A; Gervaise-Henry, C; Pernin, M; Naulet, P; Junca-Laplace, C; Lapierre-Combes, M

    2016-04-01

    Computed tomography (CT) has become the reference technique in medical imaging for renal colic, to diagnose, plan treatment and explore differential diagnosis. Its main limitation is the radiation dose, especially as urinary stone disease tends to relapse and mainly affects young people. It is therefore essential to reduce the CT radiation dose when renal colic is suspected. The goal of this review was twofold. First, we wanted to show how to use low-dose CT in patients with suspected renal colic in current clinical practice. Second, we wished to discuss the different ways of reducing CT radiation dose by considering both behavioral and technological factors. Among the behavioral factors, limiting the scan coverage area is a straightforward and effective way to reduce the dose. Improvement of technological factors relies mainly on using automatic tube current modulation, lowering the tube voltage and current as well using iterative reconstruction. PMID:26522944

  8. Imaging studies of excretory urography and computed tomography scan for patients suffering from renal colic

    Shimizu, Hirofumi [Yashio Chuo General Hospital, Saitama (Japan); Hariu, Kyouichi; Tohyama, Yuichi; Kamiyama, Yutaka; Iiyama, Tetsuro; Tomomasa, Hiroshi; Yazaki, Tsunetada; Umeda, Takashi

    1998-02-01

    Renal colic mainly due to urolithiasis is one of the most common morbid conditions in urology and commonly seen in the urology emergency clinic. Imaging studies were performed to evaluate the upper urinary tract of 29 patients suffering from renal colic in the 2 years between November, 1994 and October, 1996. After intramuscular injection of the analgesic (pentazocine, 15 mg), all 29 patients were examined by excretory urography (IVP) at the time of the first visit. In some patients abdominal plain computed tomography (CT) scan was performed consecutively even when extravasation of the contrast medium was not seen. Spontaneous peripelvic extravasation was seen in 14 patients (11 males and 3 females) with urolithiasis; 7 of them were diagnosed by IVP, 5 by IVP plus CT scan and 2 with CT scan only. IVP imaging study followed by plain abdominal CT scan is useful even when the contrast medium is not extravasated on IVP in patients suffering from renal colic. (author)

  9. 多层螺旋CT平扫联合尿路重建在急性肾绞痛诊断中的临床应用%Clinical application of multi-slice helical CT plain scan combined with urinary reconstruction in diagnosis of acute renal colic

    陈刚; 吴小候; 尹志康; 何云锋

    2011-01-01

    目的 探讨多层螺旋CT平扫联合尿路重建在急性肾绞痛诊断中的的临床应用价值.方法 将126例急诊肾绞痛患者随机分两组:CT组(67例)和静脉尿路造影(IVU)组(59例),CT组行多层(16层或64层)螺旋CT平扫联合尿路重建,IVU组行相关准备后行腹部X线平片(KUB)联合IVU检查.在明确诊断为输尿管梗阻或输尿管结石后,急诊行输尿管镜碎石术或置管治疗,比较两组患者的术前结石确诊率、肾绞痛缓解时间、住院时间及住院总费用等.结果 所有患者术后肾绞痛均缓解,CT组术前结石确诊率明显高于IVU组(P<0.05),CT组肾绞痛缓解时间和住院时间短于IVU组(P<0.05),CT组住院总费与IVU组比较差异无统计学意义(P>0.05).结论 多层螺旋CT平扫联合尿路重建对于急诊肾绞痛患者的诊治是高效和相对经济的.%Objective To investigate clinical application of multi-slice helical CT plain scan combined with urinary reconstruction in diagnosis of acute renal colic. Methods 126 patients with acute renal colic were randomized divided into two groups. 67 cases were diagnosed by multi-slice helical CT combined with urinary reconstruction and 59 cases were diagnosed by abdominal plain film radiography combined with IVU. All patients were treated by ureteroscope lithotripsy. The stone diagnosis rate was compared as well as the renal colic time , the hospitalization time and the hospitalization cost. Results The stone diagnosis rate in CT group was more than that in IVU group(P<0. 05). However,the renal colic time hospitalization time in CT group was less than that in IVU group as well as hospitalization time(P<0. 05). There was no significantly difference on the hospitalization cost between two groups(P>0. 05). Conclusion Multi-slice helical CT plain scan combined with urinary reconstruction is efficient and economic in diagnosis of acute renal colic.

  10. 间苯三酚联合黄体酮和哌替啶治疗急性肾绞痛的临床观察%Clinical observation of phloroglucinol with progesterone and pethidine for the treatment of patients with acute renal colic

    杨文波; 刘咏英

    2015-01-01

    目的:分析、探讨间苯三酚联合黄体酮和哌替啶治疗急性肾绞痛的临床应用价值。方法:收治急性肾绞痛患者120例,随机平分为两组,对照组单纯应用哌替啶肌内注射治疗,观察组应用间苯三酚和黄体酮,观察、对比两组患者的疼痛缓解时间、治疗有效率和治疗满意度。结果:观察组患者的疼痛缓解时间明显短于对照组;观察组患者的治疗有效率及治疗满意度明显高于对照组,P<0.05,差异有统计学意义。结论:临床中在处理急性肾绞痛的患者时,减少哌替啶的应用次数,应用间苯三酚和黄体酮,不仅能明显缩短疼痛消失的时间,还能提高患者的治疗满意度。%Objective:To analyze the clinical value of phloroglucinol with progesterone and pethidine for the treatment of patients with acute renal colic.Methods:120 patients with acute renal colic were selected,they were randomly divided into the two groups on average,Patients in the control group with simple application of pethidine intramuscular injection treatment,patients in the observation group used phloroglucinol and progesterone.We observed and compared the pain relief time,the effective rate of treatment,and the satisfaction degree of patients in the two groups.Results:The pain relief time of the observation group was significantly shorter than that of the control group,the effective rate and treatment satisfaction of the observation group were significantly higher than those in the control group,the differences were statistically significant P<0.05.Conclusion:In the clinical treatment of patients with acute renal colic,reduce the number of applications for the use of pethidine,with the application of phloroglucinol and progesterone,not only can significantly shorten the time of pain disappeared,but also improve patient satisfaction.

  11. Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi

    Yilmaz, S.; Sindel, T.; Arslan, G.; Oezkaynak, C.; Karaali, K.; Kabaalioglu, A.; Lueleci, E. [Department of Radiology, Akdeniz University Medical Faculty, Arapsuyu, Antalya (Turkey)

    1998-03-01

    The aim of our study was to compare noncontrast spiral CT, US and intravenous urography (IVU) in the evaluation of patients with renal colic for the diagnosis of ureteral calculi. During a period of 17 months, 112 patients with renal colic were examined with spiral CT, US and IVU. Fifteen patients were lost to follow-up and excluded. The remaining 97 patients were defined to be either true positive or negative for ureterolithiasis based on the follow-up data. Sensitivity, specificity, positive and negative predictive value and accuracy of spiral CT, US and IVU were determined, and secondary signs of ureteral stones and other pathologies causing renal colic detected with these modalities were noted. Of 97 patients, 64 were confirmed to have ureteral calculi based on stone recovery or urological interventions. Thirty-three patients were proved not to have ureteral calculi based on failure to recover a stone and diagnoses unrelated to ureterolithiasis. Spiral CT was found to be the best modality for depicting ureteral stones with a sensitivity of 94 % and a specificity of 97 %. For US and IVU, these figures were 19, 97, 52, and 94 %, respectively. Spiral CT is superior to US and IVU in the demonstration of ureteral calculi in patients with renal colic, but because of its high cost, higher radiation dose and high workload, it should be reserved for cases where US and IVU do not show the cause of symptoms. (orig.) With 4 figs., 3 tabs., 12 refs.

  12. Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi

    The aim of our study was to compare noncontrast spiral CT, US and intravenous urography (IVU) in the evaluation of patients with renal colic for the diagnosis of ureteral calculi. During a period of 17 months, 112 patients with renal colic were examined with spiral CT, US and IVU. Fifteen patients were lost to follow-up and excluded. The remaining 97 patients were defined to be either true positive or negative for ureterolithiasis based on the follow-up data. Sensitivity, specificity, positive and negative predictive value and accuracy of spiral CT, US and IVU were determined, and secondary signs of ureteral stones and other pathologies causing renal colic detected with these modalities were noted. Of 97 patients, 64 were confirmed to have ureteral calculi based on stone recovery or urological interventions. Thirty-three patients were proved not to have ureteral calculi based on failure to recover a stone and diagnoses unrelated to ureterolithiasis. Spiral CT was found to be the best modality for depicting ureteral stones with a sensitivity of 94 % and a specificity of 97 %. For US and IVU, these figures were 19, 97, 52, and 94 %, respectively. Spiral CT is superior to US and IVU in the demonstration of ureteral calculi in patients with renal colic, but because of its high cost, higher radiation dose and high workload, it should be reserved for cases where US and IVU do not show the cause of symptoms. (orig.)

  13. Ureteral Stent Insertion in the Management of Renal Colic during Pregnancy

    Choi, Chang Il; Yu, Young Dong; Park, Dong Soo

    2016-01-01

    To determine an optimal invasive intervention for renal colic patients during pregnancy after conservative treatments have been found to be unhelpful. Among the available invasive interventions, we investigated the reliability of a ureteral stent insertion, which is considered the least invasive intervention during pregnancy. Between June 2006 and February 2015, a total of 826 pregnant patients came to the emergency room or urology outpatient department, and 39 of these patients had renal col...

  14. 针刺内关与足三里治疗急性肾绞痛疗效分析%Analysis of therapeutic effect of acupuncture at Neiguan (PC 6) and Zusanli (ST 36) on acute renal colic

    琚保军; 牛琳琳

    2012-01-01

    目的:观察针刺与药物在治疗急性肾绞痛的疗效差异,验证内关和足三里联合针刺的临床效应.方法:240例患者随机分为针刺组、东莨菪碱组、杜冷丁组,各80例.针刺组选取针刺单侧或双侧内关与足三里;东莨菪碱组采取东莨菪碱肌肉注射,并配合东莨菪碱静脉滴注;杜冷丁组采取杜冷丁肌肉注射.于进针或用药30 min后观察各组临床疗效,并比较起效时间和不良反应情况.结果:针刺组总有效率为95.0%(76/80),东莨菪碱组为76.3%(61/80),杜冷丁组为92.5%(74/80),针刺组与杜冷丁组疗效相当(P>0.05),两者均优于东莨菪碱组(均P<0.05).针刺组起效时间为(13.24±2.12) min,明显快于东莨菪碱组(23.11±6.22) min和杜冷丁组(22.17±3.15)min(均P<0.05);针刺组不良反应发生较其他两组明显减少(均P<0.05).结论:在急性肾绞痛治疗中应用针刺内关与足三里镇痛效果良好,不良反应发生较少,优于杜冷丁和东莨菪碱治疗.%Objective To observe the efficacy differences among acupuncture at Neiguan (PC 6) and Zusanli (ST 36) , dolantin and scopolamine in treatment of acute renal colic, and to verify the clinical effect of acupuncture at Neiguan (PC 6) and Zusanli (ST 36). Methods Two hundred and forty patients were randomly divided into an acupuncture group, a scopolamine group and a dolantin group, 80 cases in each group. The acupuncture group was treated by acupuncture at unilateral or bilateral Neiguan (PC 6) and Zusanli (ST 36). The scopolamine group was treated by intramuscular injection of scopolamine combined with intravenous drip of scopolamine, and the dolantin group was treated by intramuscular injection of dolantin. The clinical therapeutic effects were observed 30 min after drug administration or acupuncture, and the onset time of effect and adverse reactions were compared among the groups. Results The total effective rate of 95. 0% (76/80) in the.acupuncture group had

  15. Lunar Phases and Emergency Department Visits for Renal Colic Due to Ureteral Calculus.

    Andy W Yang

    Full Text Available Urolithiasis affects an estimated 5% of the population and the lifetime risk of passing a stone in the urinary tract is estimated to be 8-10%. Urinary calculus formation is highly variable and while certain risk factors such as age, gender, seasonality, anatomic abnormality, and metabolic diseases have been identified, not much is known regarding the association of environmental factors such as lunar phases on renal colic. We conducted a retrospective study to test the hypothesis that full moon phase is an environmental factor associated for increased emergency department (ED visits for renal colic due to ureteral calculus.We analyzed 559 renal colic diagnoses by the ED at the University of Nebraska Medical Center in a 24-month period and compared them with corresponding lunar phases as well as supermoon events. The lunar phases were defined as full moon ± two days, new moon ± two days, and the days in-between as normal days according to the lunar calendar. Supermoon event dates were obtained from NASA.90 cases (16.1% were diagnosed during full moon phase, 89 cases (15.9% were diagnosed during new moon phase, and 380 cases (68.0% were diagnosed during normal days. The incidence of renal colic showed no statistically significant association with lunar phases or supermoon events.In this retrospective longitudinal study with adequate power, neither full moon phase nor supermoon event exhibited an association with increased renal colic diagnoses due to ureteral calculus by the ED at the University of Nebraska Medical Center.

  16. Lunar Phases and Emergency Department Visits for Renal Colic Due to Ureteral Calculus

    Yang, Andy W.; Johnson, Justin D.; Fronczak, Carolyn M.; LaGrange, Chad A.

    2016-01-01

    Background Urolithiasis affects an estimated 5% of the population and the lifetime risk of passing a stone in the urinary tract is estimated to be 8–10%. Urinary calculus formation is highly variable and while certain risk factors such as age, gender, seasonality, anatomic abnormality, and metabolic diseases have been identified, not much is known regarding the association of environmental factors such as lunar phases on renal colic. We conducted a retrospective study to test the hypothesis that full moon phase is an environmental factor associated for increased emergency department (ED) visits for renal colic due to ureteral calculus. Methods We analyzed 559 renal colic diagnoses by the ED at the University of Nebraska Medical Center in a 24-month period and compared them with corresponding lunar phases as well as supermoon events. The lunar phases were defined as full moon ± two days, new moon ± two days, and the days in-between as normal days according to the lunar calendar. Supermoon event dates were obtained from NASA. Results 90 cases (16.1%) were diagnosed during full moon phase, 89 cases (15.9%) were diagnosed during new moon phase, and 380 cases (68.0%) were diagnosed during normal days. The incidence of renal colic showed no statistically significant association with lunar phases or supermoon events. Conclusion In this retrospective longitudinal study with adequate power, neither full moon phase nor supermoon event exhibited an association with increased renal colic diagnoses due to ureteral calculus by the ED at the University of Nebraska Medical Center. PMID:27299307

  17. 双氯芬酸钠利多卡因联合丁溴东莨菪碱治疗急性肾绞痛的临床疗效观察%Clinical Curative Effect of Diclofenac Sodium Lidocaine Combined with Scopolamine Butylbromide in the Treatment of Acute Renal Colic

    张春; 米忠友

    2013-01-01

    Objective To investigate the clinical effect of diclofenac sodium lidocaine combined with scopolamine butylbromide in the treatment of acute renal colic. Methods 1 350 patients with acute renal colic admitted to our hospital from August 2010 to February 2012 were randomly divided into group A, group B and group C, with each group 450 cases. Group A was given progesterone + atropine, group B was given pethidine + atropine and group C was given scopolamine butylbromide + diclofe-nac sodium lidocaine. The pain degree of before and after treatment were evaluated by pain scale or schematic diagram mouth scoring method ( VRS ), and the clinical effect, acute renal colic recurrence and adverse reactions were observed in the three groups. Results The VRS between the three groups showed no statistically significant difference before treatment ( F = 4. 809, P = 0. 184 ), but showed statistically significant difference after treatment ( F = 12. 461, P =0. 025 ) . The VRS of group C was significantly lower than group A and group B ( P 0. 05 ) . Clinical effect, acute renal colic recurrence and adverse reactions between the three groups showed statistically significant differences (x2 =71. 549, 13. 893 , 16. 961; P all 0. 05 ) . Conclusion Diclofenac sodium lidocaine combined with scopolamine butylbromide should be recommended in clinic because it is significant effective with fewer adverse events.%目的 探讨双氯芬酸钠利多卡因联合丁溴东莨菪碱治疗急性肾绞痛的临床疗效.方法选择2010年8月-2012年2月我院收治的1 350例急性肾绞痛患者,随机分为A、B、C 3组,每组各450例.A组采用黄体酮+阿托品治疗,B组采用哌替啶+阿托品治疗,C组采用双氯芬酸钠利多卡因+丁溴东莨菪碱治疗.采用疼痛标尺或示意图的口诉评分法(VRS评分)评价治疗前后疼痛程度,并观察3组的临床疗效、急性肾绞痛复发情况及不良反应发生情况.结果 3组治疗前VRS评分比

  18. Clinical efficacy of Spasmofen® suppository in the emergency treatment of renal colic: a randomized, double-blind, double-dummy comparative trial

    Yakoot, Mostafa

    2014-01-01

    Mostafa Yakoot,1 Amel Salem,2 Sameh Yousef,2 Sherine Helmy31Green Clinic and Research Center, 2Alexandria Helmy Medical Center, 3Pharco Corporation, Alexandria, EgyptBackground: Renal colic is typically characterized by the sudden onset of severe pain radiating from the flank to the groin and its acute management in emergency departments essentially aims at rapid pain relief. Spasmofen® is a brand of Amriya Pharmaceutical Industries in the form of rectal suppositories containing ketop...

  19. Application of Ureteroscope in Emergency Treatment with Persistent Renal Colic Patients during Pregnancy.

    Shilin Zhang

    Full Text Available Although the application of ureteroscopy in the treatment of ureteral calculi during pregnancy has been on the rise, for persistent renal colic patients without ultrasound-detected ureteral calculi, it may represent a clinical dilemma due to the potential risks for both mother and fetus.The aim of the present study is to present our experience with the application of the ureteroscope in the emergency treatment of persistent renal colic patients during pregnancy.From March 2009 to September 2014, a total of 117 pregnant women who received ureteroscopy for persistent renal colic were retrospectively analyzed. Patients were divided into three groups according to duration of the persistent renal colic: Group A (within 12 hours; 24 cases; Group B (12 to 24 hours; 76 cases; and Group C (more than 24 hours; 17 cases. The stone-free rate, complications, and other qualitative data were analyzed.Of the 117 patients, 31 patients who were found not to have renal or ureteral calculi received ureteroscopic double-J (DJ stent insertion, whereas 86 patients who were found with ureteral calculi received ureteroscopic lithotripsy (URSL and DJ stent insertion. Among them, 24 patients (27.9% were found with ureteral calculi by ureteroscopy rather than ultrasound. In addition, 73 patients (84.9% had complete fragmentation of calculi; 12 patients (10.3% had a threatened abortion (the rates of threatened abortion in Groups A, B and C were 8.3% vs. 6.5% vs. 29.4%; Group C compared with Groups A and B, p<0.05, and one patient (1.2% had urosepsis (in Group C. However, these complications were cured with conservative treatment, without postpartum infant and maternal complications.For pregnant patients with persistent renal colic/ureteral calculi and hydronephrosis, ureteroscopic DJ stent insertion and URSL are effective and safe options when conservative treatment fails, even if no urinary calculi were found by ultrasound. At the same time, for patients with persistent

  20. Comparison of the number of patients admitted with renal colic during various stages of peri-ramadan month

    Norouzy Abdolreza; Afroushte Omalbanin; Toosi Seyedeh Mahdieh; Mohamadzade Rezaie Mohammad Ali; Mohajeri Seyed Amir Reza; Sabery Maryam; Nematy Mohsen

    2011-01-01

    Ramadan fasting for Muslims means abstinence from eating, drinking, and smoking from sunrise to sunset. There are concerns whether the occurrence of renal colic increases during the month of Ramadan. In view of the importance of fasting among Muslims, the occurrence of renal colic during Ramadan fasting has been compared during the following periods: two weeks before commencement of Ramadan (stage-1), during the first two weeks (stage-2), the last two weeks (stage-3), and, two weeks after Ram...

  1. Comparison of the number of patients admitted with renal colic during various stages of peri-ramadan month

    Norouzy Abdolreza

    2011-01-01

    Full Text Available Ramadan fasting for Muslims means abstinence from eating, drinking, and smoking from sunrise to sunset. There are concerns whether the occurrence of renal colic increases during the month of Ramadan. In view of the importance of fasting among Muslims, the occurrence of renal colic during Ramadan fasting has been compared during the following periods: two weeks before commencement of Ramadan (stage-1, during the first two weeks (stage-2, the last two weeks (stage-3, and, two weeks after Ramadan (stage-4. This was a prospective observational study, which was carried out in patients with symptoms of renal colic who were referred to the emergency wards in two major hospitals in Iran. During the study period, 610 subjects were admitted with renal colic during the four periods of study; there were 441 males (72.3% and 169 females (27.7%. The number of patients with renal colic was highest during the first two weeks of Ramadan in comparison with the other periods (stage-1: 157, stage-2: 195, stage-3: 139, stage-4: 119, P < 0.05]. Results from this study show that the number of admissions due to renal colic was high during the first two weeks of Ramadan. However, the number of admissions decreased during the last two weeks of Ramadan and this trend continued after Ramadan.

  2. Clinical efficacy of Spasmofen® suppository in the emergency treatment of renal colic: a randomized, double-blind, double-dummy comparative trial

    Yakoot M

    2014-05-01

    Full Text Available Mostafa Yakoot,1 Amel Salem,2 Sameh Yousef,2 Sherine Helmy31Green Clinic and Research Center, 2Alexandria Helmy Medical Center, 3Pharco Corporation, Alexandria, EgyptBackground: Renal colic is typically characterized by the sudden onset of severe pain radiating from the flank to the groin and its acute management in emergency departments essentially aims at rapid pain relief. Spasmofen® is a brand of Amriya Pharmaceutical Industries in the form of rectal suppositories containing ketoprofen 100 mg and hyoscine butylbromide 10 mg. This combination is intended for the rapid relief of severe colicky pain in the renal system, hepatobiliary system, or gastrointestinal tract. This trial aims to compare a single-dose of Spasmofen rectal suppository to a single intravenous (IV ketorolac tromethamine 30 mg/2 mL dose in patients with acute renal colic.Methods: A total of 80 eligible consecutive patients presenting to the emergency departments of two medical centers with acute renal colic were included in the study. Eligible patients who signed the informed consent were randomly assigned into two treatment groups: an experimental group (Spasmofen group who received one Spasmofen rectal suppository plus an IV injection of 2 mL of normal saline solution; and a control group (ketorolac group who received one ketorolac 30 mg/2 mL ampoule IV plus one placebo suppository. Treatment success, defined as a change in the verbal rating score from severe or moderate pain to none or mild at 60 minutes after the dose, was compared between groups using the chi-square/Fisher's exact test. Percentage reductions in visual pain analog scale (VPAS scores at 15 and 60 minutes after the dose were compared between groups using the Z-test for proportions.Results: Successful treatment at 60 minutes occurred in 35 of 40 (87.5% of Spasmofen-treated patients and in 33 of 40 (82.5% of ketorolac-treated patients. The difference was not statistically significant by Fisher's exact test

  3. Diagnosis and treatment of 60 patients with renal colic%肾绞痛60例的诊断和治疗

    张晖

    2016-01-01

    Objective:To investigate the diagnosis and drug treatment of patients with acute renal colic.Methods:60 patients with renal colic were selected.B ultrasound and CT of urinary system in middle lower abdomen were as examination methods. Diclofenac sodium and pethidine combined with tamsulosin hydrochloride were as therapy drugs.Results:In this group,60 cases of renal colic were diagnosed as upper urinary calculi,in which 39 cases relied on B ultrasound diagnosis of urinary calculi and 21 cases were relied on CT examination and diagnosis.Among the patients treated with drugs,59 cases were effective,and 1 case was ineffective who treated with ureteral stent implantation.Conclusion:The diagnosis and treatment of acute renal colic can be adjusted according to the condition of the disease.%目的:探讨急性肾绞痛诊断和药物治疗。方法:收治肾绞痛患者60例,选B超和中下腹泌尿系CT作为检查方法。药物治疗选用双氯芬酸钠和杜冷丁联合盐酸坦索罗辛。结果:本组60例肾绞痛均诊断为上尿路结石,其中依靠B超诊断上尿路结石39例,依靠CT检查诊断21例。给予药物治疗有效59例,无效1例,给予输尿管支架植入术。结论:急性肾绞痛的诊断治疗可根据病情而进行适当调整。

  4. Parenteral lidocaine for treatment of intractable renal colic: a case series

    Vaezi Hassan

    2011-06-01

    Full Text Available Abstract Introduction We report a case series of successful treatment of intractable renal colic using parenteral lidocaine. Case presentation Because of inconsistent responses to standard treatment with opioids and non-steroidal anti-inflammatory drugs in patients with renal colic pain, we decided to begin a trial of a single intravenous dose of lidocaine (approximately 1.5 mg/kg slowly in eight patients with intractable renal colic who were referred to our emergency medicine department. The patients were six men and two women with a mean age at diagnosis of 34.62 years (age range, 28 to 42 years. The patients were of Iranian ethnic origin. The patients' degree of pain, based on Visual Analog Scale score upon entering our emergency medicine department, was recorded 10, 20, and 30 minutes after lidocaine injection. The patients' degree of pain decreased from a mean Visual Analog Scale score (±SD of 8.87 ± 0.99 (95% confidence interval (95% CI 8.04 to 9.70 to a mean Visual Analog Scale score (±SD of 1 ± 2.82 (95% CI -1.36 to 3.36 before and 30 minutes after lidocaine treatment, respectively. Two of eight patients experienced transient mild dizziness, and three of eight patients experienced minimal slurring of speech. No patient experienced serious adverse events. Conclusion Parenteral lidocaine treatment can reduce pain dramatically or subtly.

  5. Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic

    Sakir Ongun; Sermin Coban; Abdullah Katgi; Funda Obuz; Aykut Kefi

    2014-01-01

    A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosi...

  6. Functional evaluation of the urinary tract by color-Doppler ultrasonography (CDU) in 100 patients with renal colic

    Pepe, Pietro E-mail: piepepe@hotmail.com; Motta, Luigi; Pennisi, Michele; Aragona, Francesco

    2005-01-01

    Introduction and objective: To evaluate if the addition of a renal color-Doppler ultrasonography (CDU) in the setting of acute renal colic improves the sensitivity of conventional sonography. Materials and methods: Between July 2002 and June 2003, 100 patients (median 49 years) with renal colic have been evaluated. Within 24 h of the admission, a CDU study of the urinary tract was performed using a sonograph GE Logiq 500 PRO with a multifrequency (3-5 MHz) convex probe. The following parameters were evaluated: ultrasonography (US) of both kidneys, ureters and bladder; resistive index (RI) of the arciform arteries of both kidneys in three different parenchymal areas; ureteric jets in response to hydration. A renal RI >0.70 and/or a 10% difference between the kidneys were considered as diagnostic of obstructive uropathy; an asymmetric and/or reduced ureteric jet from the ureteric orifices was an additional indicator of obstruction. All patients underwent a CT scan both with and without the administration of contrast medium. Results: Enhanced helical CT demonstrated an urinary stone in 90 out of the 100 patients (90%): 29 pyelic, 28 at the pyelo-ureteral junction, 23 lumbo-iliac and 10 juxtavesical stones. Among 90 patients with urolithiasis, the stone was undetectable with US in 11 cases (12.2%); in 8 cases (8.9%) pyelocalicectasis was absent, and in 6 patients (6.6%) a non-obstructive hydronephrosis was present. Median RI in obstructed and non-obstructed kidney was 0.73 (range 0.71-0.87) versus 0.62 (0.50-0.68), respectively; in two, obstructed kidneys RI was <0.70 but greater than 10% compared with normal side. Sensitivity and specificity of US, CDU (RI + ureteric jet), unenhanced helical CT and CDU in association with unenhanced helical CT were 94.8 and 55.5, 98.9 and 90.9, 100 and 100%, respectively. Discussion and conclusions: CDU in patients with renal colic and/or pelvicalicectasis improves the diagnostic accuracy of US in distinguishing between obstructive

  7. Functional evaluation of the urinary tract by color-Doppler ultrasonography (CDU) in 100 patients with renal colic

    Introduction and objective: To evaluate if the addition of a renal color-Doppler ultrasonography (CDU) in the setting of acute renal colic improves the sensitivity of conventional sonography. Materials and methods: Between July 2002 and June 2003, 100 patients (median 49 years) with renal colic have been evaluated. Within 24 h of the admission, a CDU study of the urinary tract was performed using a sonograph GE Logiq 500 PRO with a multifrequency (3-5 MHz) convex probe. The following parameters were evaluated: ultrasonography (US) of both kidneys, ureters and bladder; resistive index (RI) of the arciform arteries of both kidneys in three different parenchymal areas; ureteric jets in response to hydration. A renal RI >0.70 and/or a 10% difference between the kidneys were considered as diagnostic of obstructive uropathy; an asymmetric and/or reduced ureteric jet from the ureteric orifices was an additional indicator of obstruction. All patients underwent a CT scan both with and without the administration of contrast medium. Results: Enhanced helical CT demonstrated an urinary stone in 90 out of the 100 patients (90%): 29 pyelic, 28 at the pyelo-ureteral junction, 23 lumbo-iliac and 10 juxtavesical stones. Among 90 patients with urolithiasis, the stone was undetectable with US in 11 cases (12.2%); in 8 cases (8.9%) pyelocalicectasis was absent, and in 6 patients (6.6%) a non-obstructive hydronephrosis was present. Median RI in obstructed and non-obstructed kidney was 0.73 (range 0.71-0.87) versus 0.62 (0.50-0.68), respectively; in two, obstructed kidneys RI was <0.70 but greater than 10% compared with normal side. Sensitivity and specificity of US, CDU (RI + ureteric jet), unenhanced helical CT and CDU in association with unenhanced helical CT were 94.8 and 55.5, 98.9 and 90.9, 100 and 100%, respectively. Discussion and conclusions: CDU in patients with renal colic and/or pelvicalicectasis improves the diagnostic accuracy of US in distinguishing between obstructive

  8. Acute phase proteins as diagnostic markers in horses with colic

    Pihl, Tina Holberg; Scheepers, Elrien; Sanz, Macarena;

    and fibrinogen to differentiate between horses with infectious non-surgical colic and surgical colic. Materials & Methods:The performance of the APPs was evaluated individually and in combination with clinical examination, as wells as traditional biomarkers in blood (WCC, PCV, TPP, lactate) and peritoneal fluid...... (PF) (haemolysis, WCC, total protein).Admission data collected prospectively from 148 horses with severe colic in one hospital was used to construct multivariate logistic models to predict if a horse had an infectious non-surgical colic. The models were based on 1) clinical evaluation, 2) clinical...... and blood evaluation and 3) clinical, blood and PF evaluation. Each model was independently validated against admission data from 78 horses in another hospital.Results and Discussion:The variables included in the final ‘clinical model’ were: Lethargy, temperature increase from 38◦C, gastric reflux 5-10L...

  9. Spontaneous Pelvic Rupture as a Result of Renal Colic in a Patient with Klinefelter Syndrome

    Sergey Reva; Yuri Tolkach

    2013-01-01

    We present the case of a young man with Klinefelter syndrome, who was admitted to our clinic with renal colic. Shortly after admittance, spontaneous decrease in pain has occurred. Ultrasound and intravenous contrast computed tomography were performed, which showed the evidence of urine extravasation at the level of left renal pelvis and a 4 mm stone in the lower third of the left ureter. The management with a double-J ureteric stent for three weeks was successful. Then, the stent was removed ...

  10. Delayed-onset Ureteral Obstruction and Calcification Masquerading as Renal Colic Following Deflux Injection.

    Romain, Julie; Fourcade, Laurent; Centi, Joachim; Blanc, Philippe; Masselin, Mathilde Casson; Lescure, Victor; Guigonis, Vincent; Descazeaud, Aurélien; Ballouhey, Quentin

    2016-08-01

    Vesicoureteral reflux is a common disorder in children, and its management has changed entirely as a result of widespread use of endoscopy procedures to inject filler materials. Complications with this type of treatment, particularly ureteral obstruction, are rare. Very few patients with delayed obstruction have been reported in the literature. We here present the case of an 8-year-old girl who exhibited symptoms of febrile renal colic and renal distension more than 5 years after undergoing endoscopic treatment. This is the first reported case of atypical late presentation combining pyelonephritis with ureteral obstruction and calcification. PMID:26970448

  11. Perioperative acute renal failure.

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  12. Young Patients with Suspected Uncomplicated Renal Colic are Unlikely to Have Dangerous Alternative Diagnoses or Need Emergent Intervention

    Schoenfeld, Elizabeth M; Poronsky, Kye E.; Elia, Tala R.; Budhram, Gavin R.; Garb, Jane L.; Mader, Timothy J.

    2015-01-01

    Introduction: In the United States there is debate regarding the appropriate first test for new-onsetrenal colic, with non-contrast helical computed tomography (CT) receiving the highest ratings fromboth Agency for Healthcare Research and Quality and the American Urological Association. This isbased not only on its accuracy for the diagnosis of renal colic, but also its ability to diagnose othersurgical emergencies, which have been thought to occur in 10-15% of patients with suspected renalco...

  13. Clinical study of diclofenac, phloroglucinol and progesterone in the treatment of acute renal colic%双氯芬酸钠联合间苯三酚和黄体酮治疗急性肾绞痛的临床研究

    瞿虎; 袁浩锋; 马波; 汪中扬

    2015-01-01

    目的 研究双氯芬酸钠联合间苯三酚等药物治疗急性肾绞痛的临床效果.方法 选取2011年9月至2013年3月中山大学附属第六医院泌尿外科收治的急性肾绞痛患者146例,随机分为观察组与对照组,每组73例.均给予间苯三酚注射液及黄体酮注射液联合治疗,观察组再给予复方双氯芬酸钠注射液治疗,观察治疗效果.结果 观察组治疗前后VAS结果分别为(7.54±2.11)分和(2.57±1.32)分,对照组分别为(7.34±2.32)分和(3.76±1.22)分.两组患者治疗前VAS比较差异无统计学意义(t=0.43,P>0.05),治疗后观察组VAS结果有所改善,且改善程度优于对照组(t =2.57,P<0.05).而且两组患者各种并发症发生率比较差异无统计学意义(P>0.05).观察组治疗总有效率高于对照组(x2=4.76,P<0.05).结论 双氯芬酸钠、间苯三酚及黄体酮联合治疗急性肾绞痛临床效果满意,可有效减轻患者疼痛,提高治疗总有效率,建议在临床治疗中推广应用.%Objective To study the clinical effect of diclofenac,phloroglucinol and progesterone on acute renal colic.Methods From November 2011 to March 2013,146 patients with acute renal colic in our hospital were randomly divided into treatment group and control group,with 73 cases in each group.They were treated with phloroglucinol and progesterone,and the patients in treatment group were treated with diclofenac on the basis of phloroglucinol and progesterone.The clinical effects were observedafter treatment.Results The VAS value of treatment group before and after treatment was(7.54 ± 2.11) and (2.57 ± 1.32) respectively.The VAS value of control group before and after treatment was (7.34 ± 2.32) and (3.76 ± 1.22) respectively.The VAS value of treatment group was significantly higher than that of control group after treatment (t =2.57,P < 0.05).There was no significant difference in the incidence of complications between the two groups(P >0.05).And the total treatment

  14. Understanding on Treatment of Emergent Renal Colic%肾绞痛急诊治疗体会

    马吾浪·乌布利艾拉; 艾力·马合木提; 景海涛

    2011-01-01

    To explore the optimal solution of treating acute renal colic through comparison of several pain relief methods from the clinical data of 3358 patients with acute renal colic. Methods The clinical data of 3358 cases of acute renal colic were randomly grouped, treated with the following methods: anticonvulsive drug + M-receptor blocking agent; weak opioid agent + M-receptor blocking agent; non-steroid anti-inflammatory drug + M-receptor blocking agent; strong opioid agent. The pain-relief effect of administration within 30 minutes was evaluated. Results The total effectiveness of anticonvulsive drug + M-receptor blocking agent was 92% ,of weak opioid agent + M-receptor blocking agent was 73% ,of non-steroid anti-inflammatory drug + M-receptor blocking agent was 95% , of strong opioid agent was 96. 2%. Efficacy of non-steroid anti-inflammatory drug + M-receptor blocking agent is better than anticonvulsive drug + M-receptor blocking agent and weak opioid agent + M-receptor blocking agent( P < 0.05 ), adverse effect situation was better than the strong opioid agent group. Conclusion The non-steroid anti-inflammatory drug + M-receptor blocking agent can take the place of the strong opioid agent as treatment for severe renal colic.%目的 通过对3358例急性肾绞痛患者的回顾性分析,对常用的几种缓解疼痛的方法进行比较,探寻治疗重度肾绞痛的最佳方案.方法 确诊重度肾绞痛患者3358例随机分组,采用以下止痛方法:解痉药+M受体阻滞药;弱阿片类药+M受体阻滞药;非甾体类抗炎药+M受体阻滞药;强阿片类药物.评价给药30 min内疼痛缓解的效果并进行分析.结果 解痉药+M受体阻滞药组总有效率92%,弱阿片类药+M受体阻滞剂组总有效率73%,非甾体类抗炎药+M受体组总有效率95%,强阿片类药物组总有效率96.2%.非甾体类抗炎药+M受体组疗效优于解痉药+M受体阻滞药组和弱阿片类药+M受体阻滞剂组(P<0.05),不良反应发生情况优

  15. Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic

    Sakir Ongun

    2014-01-01

    Full Text Available A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosis of chronic myeloproliferative disease. The trombus was completely recanalized at 3-month followup.

  16. Young Patients with Suspected Uncomplicated Renal Colic are Unlikely to Have Dangerous Alternative Diagnoses or Need Emergent Intervention

    Schoenfeld, Elizabeth M.

    2015-03-01

    Full Text Available Introduction: In the United States there is debate regarding the appropriate first test for new-onset renal colic, with non-contrast helical computed tomography (CT receiving the highest ratings from both Agency for Healthcare Research and Quality and the American Urological Association. This is based not only on its accuracy for the diagnosis of renal colic, but also its ability to diagnose other surgical emergencies, which have been thought to occur in 10-15% of patients with suspected renal colic, based on previous studies. In younger patients, it may be reasonable to attempt to avoid immediate CT if concern for dangerous alternative diagnosis is low, based on the risks of radiation from CTs, and particularly in light of evidence that patients with renal colic have a very high likelihood of having multiple CTs in their lifetimes. The objective is to determine the proportion of patients with a dangerous alternative diagnosis in adult patients age 50 and under presenting with uncomplicated (non-infected suspected renal colic, and also to determine what proportion of these patients undergo emergent urologic intervention. Methods: Retrospective chart review of 12 months of patients age 18-50 presenting with “flank pain,” excluding patients with end stage renal disease, urinary tract infection, pregnancy and trauma. Dangerous alternative diagnosis was determined by CT. Results: Two hundred and ninety-one patients met inclusion criteria. One hundred and fifteen patients had renal protocol CTs, and zero alternative emergent or urgent diagnoses were identified (one-sided 95% CI [0-2.7%]. Of the 291 encounters, there were 7 urologic procedures performed upon first admission (2.4%, 95% CI [1.0-4.9%]. The prevalence of kidney stone by final diagnosis was 58.8%. Conclusion: This small sample suggests that in younger patients with uncomplicated renal colic, the benefit of immediate CT for suspected renal colic should be questioned. Further studies are

  17. Renal colic, where is it headed? An observational study

    Paolo Beltrami; Andrea Guttilla; Lorenzo Ruggera; Patrizia Bernich; Filiberto Zattoni

    2016-01-01

    Aim: In the last thirty years, the treatment for renal and ureteral calculi has undergone profound variations. The objective of this study has been to evaluate the existence of parameters which can affect the spontaneous expulsion of a symptomatic ureteral stone in a reasonably brief period of time and to identify whether certain parameters such as sex, age, the location and dimension of the stone, the presence of dilation in the urinary tract together with the administered therapy, can be us...

  18. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department

    Soleimanpour Hassan

    2012-05-01

    Full Text Available Abstract Background Despite the fact that numerous medications have been introduced to treat renal colic, none has been proven to relieve the pain rapidly and thoroughly. In this study, we aimed at comparing the effects of intravenous lidocaine versus intravenous morphine in patients suffering from renal colic. Methods In a prospective randomized double-blind clinical trial performed in the emergency department of Imam Reza educational hospital of Tabriz, Iran, we studied 240 patients, 18–65 years old, who were referred due to renal colic. Patients were divided into two groups. In group I (120 people single-dose intravenous lidocaine (1.5 mg/kg was administered and in group II (120 people single-dose intravenous morphine (0.1 mg/kg was administered slowly. Visual Analogue Pain Scale (VAS was recorded while admission, 5, 10, 15 and 30 minutes after injection. Statistical data and results were studied using descriptive statistics as percentage and Mean ± SD. To compare the response to treatment, Mann–Whitney U-test was used in two groups. Consequently, the data were analyzed using the SPSS16 software. Results Pain score measured in two groups five minutes after the injection of lidocaine and morphine were 65 % and 53 % respectively (95% CI 0.60 - 0.69, CI 0.48 – 0.57, p = 0.0002.108 (90 % patients (95 % CI 0.84 – 0.95 from group I and 84 (70% patients (95 % CI 0.62 - 0.78 from group II responded appropriately at the end of the complete treatment. The difference was statistically significant (p = 0.0001. Conclusions Changing the smooth muscle tone and reducing the transmission of afferent sensory pathways, lidocaine causes a significant reduction in pain. Trial registration Clinical Trials IRCT138901042496N3

  19. Ureteral Stent Insertion in the Management of Renal Colic during Pregnancy.

    Choi, Chang Il; Yu, Young Dong; Park, Dong Soo

    2016-05-01

    To determine an optimal invasive intervention for renal colic patients during pregnancy after conservative treatments have been found to be unhelpful. Among the available invasive interventions, we investigated the reliability of a ureteral stent insertion, which is considered the least invasive intervention during pregnancy. Between June 2006 and February 2015, a total of 826 pregnant patients came to the emergency room or urology outpatient department, and 39 of these patients had renal colic. The mean patient age was 30.49 years. In this retrospective cohort study, the charts of the patients were reviewed to collect data that included age, symptoms, the lateralities and locations of urolithiasis, trimester, pain following treatment and pregnancy complications. Based on ultrasonography diagnoses, 13 patients had urolithiasis, and 13 patients had hydronephrosis without definite echogenicity of the ureteral calculi. Conservative treatments were successful in 25 patients. Among these treatments, antibiotics were used in 15 patients, and the remaining patients received only hydration and analgesics without antibiotics. Several urological interventions were required in 14 patients. The most common intervention was ureteral stent insertion, which was performed in 13 patients to treat hydronephrosis or urolithiasis. The patients' pain was relieved following these interventions. Only one patient received percutaneous nephrostomy due to pyonephrosis. No pregnancy complications were noted. Ureteral stent insertion is regarded as a reliable and stable first-line urological intervention for pregnant patients with renal colic following conservative treatments. Ureteral stent insertion has been found to be equally effective and safe as percutaneous nephrostomy, which is associated with complications that include bleeding and dislocation, and the inconvenience of using external drainage system. PMID:27231677

  20. Ureteral Stent Insertion in the Management of Renal Colic during Pregnancy

    Choi, Chang Il; Yu, Young Dong

    2016-01-01

    To determine an optimal invasive intervention for renal colic patients during pregnancy after conservative treatments have been found to be unhelpful. Among the available invasive interventions, we investigated the reliability of a ureteral stent insertion, which is considered the least invasive intervention during pregnancy. Between June 2006 and February 2015, a total of 826 pregnant patients came to the emergency room or urology outpatient department, and 39 of these patients had renal colic. The mean patient age was 30.49 years. In this retrospective cohort study, the charts of the patients were reviewed to collect data that included age, symptoms, the lateralities and locations of urolithiasis, trimester, pain following treatment and pregnancy complications. Based on ultrasonography diagnoses, 13 patients had urolithiasis, and 13 patients had hydronephrosis without definite echogenicity of the ureteral calculi. Conservative treatments were successful in 25 patients. Among these treatments, antibiotics were used in 15 patients, and the remaining patients received only hydration and analgesics without antibiotics. Several urological interventions were required in 14 patients. The most common intervention was ureteral stent insertion, which was performed in 13 patients to treat hydronephrosis or urolithiasis. The patients' pain was relieved following these interventions. Only one patient received percutaneous nephrostomy due to pyonephrosis. No pregnancy complications were noted. Ureteral stent insertion is regarded as a reliable and stable first-line urological intervention for pregnant patients with renal colic following conservative treatments. Ureteral stent insertion has been found to be equally effective and safe as percutaneous nephrostomy, which is associated with complications that include bleeding and dislocation, and the inconvenience of using external drainage system. PMID:27231677

  1. Keratinized squamous metaplasia of the upper urinary tract resulting in recurrent renal colic.

    Ghali, Fady; Pattison, Erik; Pais, Vernon M

    2015-10-01

    A 60-year-old female with an extensive history of stone disease and shock wave lithotripsy presents with recurrent and increasingly severe renal colic. Work-up reveals obstruction with translucent debris that is found to be composed of keratin. Her history of chronic irritation of the collecting system has resulted in keratinizing squamous metaplasia (KSM) with hyperkeratosis that has sloughed from the upper urinary tract and has become lodged in the ureter. Because of the worsening of her symptoms on conservative management, the patient elected for a nephrectomy and her symptoms have since resolved. KSM of the renal pelvis is a relatively rare phenomenon and most often presents with irritative symptoms. It is thought to result from chronic irritation of the urothelium. KSM has been found to be coincident with squamous cell cancers of the urinary tract, though clear data implicating KSM as a premalignant lesion is lacking. We present a case of recurrent renal colic secondary to sloughing keratin debris from KSM. PMID:26249552

  2. Therapeutic Effect of Papaverine Hydrochloride in Acute Calculus-caused Renal Colic Unresponsive to Conventional Treatment%盐酸罂粟碱对于常规治疗无效的结石引发急性肾绞痛疗效观察

    郭建; 丁宁; 陈晓雄

    2011-01-01

    目的 探讨盐酸罂粟碱对常规治疗无效的结石引发的急性肾绞痛的临床疗效.方法 选择2004年6月-2007年9月首都医科大学附属北京同仁医院门急诊科采用常规解痉镇痛治疗无效结石引发急性肾绞痛患者89例,随机分成3组,分别采取不同的治疗方法并评估其疗效,第1组采用山莨菪碱及赖氨匹林静脉滴注,第2组采用盐酸罂粟碱静脉滴注,第3组采用哌替啶静脉滴注.治疗前后患者均采用形象化模拟评分法(VAS)评价疼痛程度.结果 治疗1 h后,VAS评分第2组(1.05±0.23)分和第3组(0.98±0.40)分均明显低于第1组的(3.74±2.45)分,差异有统计学意义(P<0.05);第2组和第3组比较,差异无统计学意义(P>0.05).第1组和第2组患者均未出现明显不良反应,第3组9例(30.0%)患者出现轻至中度的镇定作用,2例(6.7%)患者发生轻度心动过缓和低血压.治疗4 h后仍有6例患者存在剧烈肾绞痛(VAS评分>7分),其中5例患者行体外震波碎石术后疼痛明显缓解.1例患者因结石过大体外碎石无效而入院行急诊肾造瘘术.结论 盐酸罂粟碱对于结石引起的常规治疗无效的急性肾绞痛疗效显著,可作为哌替啶等毒麻药品的替代品.%Objective To evaluate the therapeutic effect of papaverine hydrochloride in calculus - caused acute renal colic unresponsive to conventional treatment.Methods Eighty calculus - caused acute renal colic patients unresponsive to conventional treatments in Emergency Department of Beijing Tongren Hospital from 2004 to 2007 were divided randomly into groups Ⅰ ( given intravenous Raceanisodamine Hydrochloride and Aspirin - Dl - Lysine ), Ⅱ ( given intravenous papaverine hydrochloride ), Ⅲ ( given intravenous pethidine ).Pains were assessed by vision analog score ( VAS ) in all patients before or after treatment.Results After 1 h of treatment, VAS was significantly lower in groups Ⅱ, Ⅲ (1.05 ±0.23, 0.98 ±0.40, respectively ) than

  3. Hepatobiliary and pancreatic ascariasis-sonographic pictorial essay on four pediatric cases with acute biliary colic.

    Lynser, Donboklang; Marbaniang, Evarisalin

    2016-04-01

    Hepatobiliary and pancreatic ascariasis occur due to migration of the round worm ascaris lumbricoides through the bile duct orifice finally reaching the common bile duct, main pancreatic duct, intrahepatic ducts or gallbladder. These resulted in acute epigastric and right hypochondriac region colicky pain. Ultrasound is the investigation of choice in hepatobiliary ascariasis. We present here sonographic images on four pediatric patients with acute biliary colic. PMID:26690772

  4. Polyhydramnios and acute renal failure

    Hamilton, D. V.; Kelly, Moira B.; Pryor, J. S.

    1980-01-01

    Acute renal failure secondary to ureteric obstruction is described in a primigravida with twin gestation and polyhydramnios. Relief of the obstruction occurred on drainage of the liquor and return to normal renal function following delivery.

  5. Acute renal failure in children

    Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% ± 1.40 S.D.) and group B (5.95 mg% ± 1.96 S.D.), p < 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. (orig.)

  6. Analgesic Effects of Inhalation of Nitric Oxide (Entonox and Parenteral Morphine Sulfate in Patients with Renal Colic; A Randomized Clinical Trial

    Hamid Kariman

    2015-04-01

    Full Text Available Objective: To compare the analgesiceffects of Nitrous oxide and morphine sulfate in patients with acute renal colic due to urolithiasis. Methods: This was randomized clinical trial being performed in Imam Hossein hospital affiliated with Shahid Beheshti University of Medical Sciences during a 1-year period from May2013 to May2014. A total of number of 100 patients, with an age range of 20-50 years, who presented with renal colic secondary to urolithiasis confirmed by ultrasonography were randomly assigned to receive morphine sulfate injection (0.1 mg/kg with 100 mg diclofenac suppository (n=50 or Entonox exhalation (50% nitric oxide and 50% oxygenfor 30-minutes with 100 mg diclofenac suppository (n=50. Quantitative measurement was of pain was performed according to a visual analogue scale (VAS, before, 3, 5, 10 and 30-minute after the intervention. The pain severity and side effects were measured between two study groups. Results: The baseline characteristics of the patients in two study groups were comparable. The frequencies of pain persistence (at least 50% at 3-, 5-, 10- and 30-minute intervals in morphine sulfategroup were 96%, 80%, 50% and 8%, respectively; these frequencies in Entonex were 82%, 42%, 12% and 2%, respectively (p<0.001. Cox regression modeling showed that use of Entonox was the only effective agent in the success of treatment, compared to the use of morphine, i.e. use of Entonox increased the success of treatment up to 2.1 folds compared to the use of morphine (HR=2.1; 95% CI: 1.2-3.6; p=0.006. Conclusion: The results of the present study demonstrate that inhalation of Entonox is an effective and safe analgesic regimen for acute renal colic. It acts more rapidly and is more potent in relieving renal colic when compared to morphine sulfate.Entonox can be regarded as an appropriate alternative to analgesics like opioids in this ground. Clinical Trial Registry: The current study is registered with Iranian Registry for Clinical

  7. Comparing the analgesic effect of intravenous acetaminophen and morphine on patients with renal colic pain referring to the emergency department: A randomized controlled trial

    Reza Azizkhani; Seyed Mehdi Pourafzali; Elahe Baloochestani; Babak Masoumi

    2013-01-01

    Background: Kidney stone is normally treated by opioids with a variety of side-effects including hypotension, respiratory depression and apnea, nausea and vomiting. Regarding less complications of intravenous acetaminophen, we aimed to compare it with intravenous morphine in management of renal colic pain. Materials and Methods: A randomized controlled clinical trial was applied with a convenience sampling method, as 124 patients suffering from renal colic pain were randomly assigned into two...

  8. Improving the effectiveness of the emergency management of renal colic in a district general hospital: a completed audit cycle

    Kastner, C; Tagg, A

    2003-01-01

    Methods: Data were collected about the use of analgesia, waiting time for intravenous urography (IVU), and admission status of patients presenting to the hospital with symptoms of renal colic over the period of three months. A literature search into the use of analgesia, imaging, and treatment was performed. Members of the involved departments were consulted and new guidelines developed and implemented. This was followed by further data collection over three months.

  9. Non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in the patients with refractory renal colic

    Objectives: To assess the importance of combined use of non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in evaluation of patients with refractory flank pain in the emergency department. Methods: The study involved 64 consecutive patients with refractory renal colic. All patients were evaluated with plain abdominal films kidneys, ureters and bladder (KUB), NCCT and DRS. We assessed the accuracy of different diagnostic procedures and their combinations; in addition, we determined their importance for different steps of evaluation. Results: Urololithiasis was diagnosed in 76.6% (n = 49) of the patients. Twenty-nine percent of calculi were >4 mm. Surgical intervention were performed in 20 patients (40.8%). A combination of NCCT plus DRS yielded the greatest sensitivity (96%) in establishing final diagnosis, however clinical, laboratory and KUB data in combination with DRS, yielded greater specificity (93%) and PPV (97%). Sex (male), WBC (mean 10.2 x 103 ± 3.1) and KUB (calculus > 4 mm) were chosen in the three-step multi-variant analysis, while only male sex was found to be the strongest predictor (p 3 and calculi > 4 mm on the KUB

  10. Akut Renal Kolikli Hastalarda Dilaltı Piroksikam ve İntranazal Dezmopressin Kombine Tedavisinin Etkisi

    Özden, Cüneyt; Gökkaya, Cevdet Serkan; Günay, İsa; Demirdal, Özgür; Özdal, Özdem Levent; Memiş, Ali

    2009-01-01

    Introduction: Desmopressin is a synthetic antidiuretic hormone (ADH) analogue. When it is compared to ADH, the anti-diuretic effect is more and longer. In recent years it is used to relieve pain in patients with acute renal colic. In the present study we evaluated the effect of combined therapy of intranasal desmopressin spray and sublingual piroxicam in patients with acute renal colic. Materials and Methods: Forty-five patients with renal colic included into the study. Patients were rand...

  11. The curative effect of Lidocaine combined with Anisodamine (654-2) in the treatment of renal colic%利多卡因联合山莨菪碱(654-2)治疗肾绞痛的疗效

    卢智胜; 黄卓林

    2009-01-01

    位作为肾绞痛治疗的一线用药.%od for renal colic with less adverse reactions,and suitable for emergency or community-based primary health care units as a first-line medication for renal colic.

  12. Non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in the patients with refractory renal colic

    Kravchick, Sergey [Department of Urology, Barzilai Medical Center, Ashkelon (Israel); Stepnov, Eugeny [Department of Urology, Barzilai Medical Center, Ashkelon (Israel); Lebedev, Valery [Department of Radiology, Barzilai Medical Center, Ashkelon (Israel); Linov, Lina [Department of Radiology, Barzilai Medical Center, Ashkelon (Israel); Leibovici, Octavian [Department of Radiology, Barzilai Medical Center, Ashkelon (Israel); Ben-Horin, Clara L. Dosoretz [Department of Nuclear Medicin, Barzilai Medical Center, Ashkelon (Israel); Trejo, Leonardo [Department of Nuclear Medicin, Barzilai Medical Center, Ashkelon (Israel); Peled, Ronit [Epidemiology Research Institute, Ashkelon (Israel); Cytron, Shmuel [Chief Department of Urology, Barzilai Medical Center, Ashkelon (Israel)

    2006-05-15

    Objectives: To assess the importance of combined use of non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in evaluation of patients with refractory flank pain in the emergency department. Methods: The study involved 64 consecutive patients with refractory renal colic. All patients were evaluated with plain abdominal films kidneys, ureters and bladder (KUB), NCCT and DRS. We assessed the accuracy of different diagnostic procedures and their combinations; in addition, we determined their importance for different steps of evaluation. Results: Urololithiasis was diagnosed in 76.6% (n = 49) of the patients. Twenty-nine percent of calculi were >4 mm. Surgical intervention were performed in 20 patients (40.8%). A combination of NCCT plus DRS yielded the greatest sensitivity (96%) in establishing final diagnosis, however clinical, laboratory and KUB data in combination with DRS, yielded greater specificity (93%) and PPV (97%). Sex (male), WBC (mean 10.2 x 10{sup 3} {+-} 3.1) and KUB (calculus > 4 mm) were chosen in the three-step multi-variant analysis, while only male sex was found to be the strongest predictor (p < 0.056) of necessity to perform NCCT. In making decision for definitive treatment NCCT and DRS provided the most important information about stone size and obstruction (kappa = 0.734, p < 0.001 and kappa = 0.625, p < 0.001), while DRS was selected as the most important diagnostic procedure in the emergency department (kappa = 0.527, p < 0.001). Conclusions: In the emergency department, DRS combined with the results of clinical investigation may indicate candidates for hospitalization with emergency intervention. Immediate NCCT must be strongly considered in men with WBC {>=} 10 x 10{sup 3} and calculi > 4 mm on the KUB.

  13. Analysis of clinical and demographic characteristics of patients presenting with renal colic in the emergency department

    Keysan Mustafa

    2008-09-01

    Full Text Available Abstract Background Renal colic (RC, is one of the most severe pain patterns which is most commonly diagnosed and managed in the emergency department (ED. This study is designed to evaluate the characteristics of adult patients presenting with pain and diagnosed with RC in the ED, length of stay in the ED and hospital and factors affecting these variables. Methods All consecutive adult patients who presented with side pain, flank pain, abdominal or groin pain and consequently diagnosed with urolithiasis or RC were analyzed retrospectively. Sociodemographic data, times of admission into and discharge from the ED, adjunctive complaints, results of laboratory investigations, findings on examination, treatment and drugs administered were noted. Results A total of 235 patients with a diagnostic code of urolithiasis were enrolled. Physicians were more likely to order radiological and laboratory investigations for female patients and those without hematuria in urinalysis. The peak incidence of patients diagnosed with RC (p = 0.001 was noted in August, while the winter had the lowest frequency of relevant admissions. The peak frequency was between 06:00 and 08:00. Women stayed longer in the ED (p = 0.001. Absence of hematuria in urinalysis was associated with increased length of stay (p = 0.007. Conclusion Although RC is a common ED presentation for which the emergency physician has no guidelines in terms of diagnosis and management, there is no exact pattern to guide ordering investigations. Patients with atypical presentations stay longer in the ED and are likely to undergo additional tests in management.

  14. Evaluation of image quality and dose in renal colic: comparison of different spiral-CT protocols

    Rimondini, A.; Mucelli, R.P.; Dalla Palma, L. [Dept. of Radiology, University of Trieste (Italy); De Denaro, M.; Bregant, P. [Dept. of Medical Physics, Ospedale Maggiore, Trieste (Italy)

    2001-07-01

    The aim of this study was to test different technical spiral-CT parameters to obtain optimal image quality with reduced X-ray dose. Images were acquired with a spiral-CT system Philips Tomoscan AVE1, using 250 mA, 120 kV, and 1-s rotational time. Three protocols were tested: protocol A with 5-mm thickness, pitch 1.6, slice reconstruction every 2.5 mm; protocol B with 3-mm thickness, pitch 1.6, slice reconstruction every 1.5 mm; and protocol C with 3-mm thickness, pitch 2, slice reconstruction every 1.5 mm. Two phantoms were employed to evaluate the image quality. Axial images were acquired, then sagittal and coronal images were reconstructed. Finally, the absorbed X-ray dose for each protocol was measured. Regarding image quality, 5-mm-thick images (protocol A) showed greater spatial resolution and lower noise compared with 3-mm-thick images (protocols B and C) on the axial plane; 3-mm reconstructed sagittal and coronal images (protocols B and C) showed an improved image quality compared with 5-mm reformatted images (protocol A). Concerning X-ray dose, the mean dose was: protocol A 19.6{+-}0.8 mGy; protocol B 14.4{+-}0.6 mGy; protocol C 12.5{+-}1.0 mGy. Our study supports the use of thin slices (3 mm) combined with pitch of 1.6 or 2 in renal colic for X-ray dose reduction to the patient and good image quality. (orig.)

  15. 妊娠期肾绞痛的临床诊治%Diagnosis and treatment of renal colic in pregnancy

    唐国强; 张融融; 蒋冬; 徐敏; 张唯力

    2011-01-01

    目的:探索妊娠期肾绞痛的病因和治疗方法.方法:对本院90例患者进行回顾性研究,对其临床表现、影像学资料及临床治疗措施的相关性数据进行分析.结果:90例妊娠期肾绞痛患者中79例(87.8%)采用内科保守治疗,结石组患者更多需要外科干预(P<0.05),7例(7.8%)患者采用输尿管置管,4例(4.4%)输尿管镜术+弹道碎石或取石治疗.所有患者肾绞痛都得到有效缓解,并顺利度过围产期.结论:目前B超是临床首选的诊断方法.妊娠期肾绞痛患者经保守治疗大部分可以获得缓解.对妊娠期顽固性肾绞痛患者采用输尿管置管、输尿管镜术安全、有效.%To evaluate the pathogenesis and effective therapeutic manners for renal colic in pregnancy. Methods-. A retrospective review of 90 patients admitted to our institute was carried out. Correlational data on clinical manifestation,diagnostic imaging, and interventions were analyzed. Results:Among the 90 patients,79 cases(87.8%) were treated by conservative measures. The need for surgical treatment was more prevalent in patients with stone (18.9% vs 2.7% ,P<0.05). 7cases(7.8%) were treated by placing in- traureteral double-J-catheter,and 4 cases(4.4%) by placing intraureteral double-J-catheter after ureteroscopic pneumatic lithotripsy or lithotomy. All pregnant women with renal colic were alleviated and delivered of healthy babies, and went through safely perinatal period. Conclusion ; Type-B ultrasonic is a preferred manner of clincal diagnosis at present. Most pregnant women with renal colic can be alleviated by non-surgical treatment. Placement of intraureteral double-J-catheter and transurethral ureteroscopy are effective and safe methods for the treatment of refractory renal colic in pregnant period.

  16. ST segment elevation in a patient presenting with renal colic pain

    Zohair Al Aseri

    2011-01-01

    Full Text Available ST segment elevation of more than 1 mm from the baseline is an electrocardiographic presentation of acute myocardial injury. This phenomenon is not confined only to ischemic injury, and various other etiological factors have been described in relation to ST segment elevation. We report the case of a young man who presented in the emergency department complaining of loin pain. He was subsequently found to have transient ST segment elevation, but a thorough evaluation showed no evidence of coronary artery disease. ST segment elevation is one of the best tools for diagnosing acute myocardial infarction, of which reperfusion therapy is the treatment of choice thus making it important to make the diagnosis as quickly as possible. It is equally important, however, not to misdiagnose acute myocardial infarction, as there are other causes of ST segment elevation. Therefore, we report this unique case of renal pain due to stone causing ST segment elevation.

  17. Analysis on Effect of Drug Therapy for 80 Cases with Renal Colic%80例肾绞痛的药物治疗及疗效分析

    杨瑞洲

    2014-01-01

    Objective:To analyze renal colic patients and to observe the renal colic patients treated with the drug. Method:From 2008 September to 2013 December,to observe the curative effect of 80 drug renal colic patients in emergency surgery in our hospital. Result:97.5%patients with renal colic was caused by urinary tract stones,stones of 78 patients,54 cases of diameter≤0.8 cm with renal colic symptoms were relieved,the average drug treatment for 3-5 days,hydronephrosis relieved,the stones from in vitro. Conclusion:Patients,drug treatment of stone diameter≤0.8 cm method is simple,reliable curative effect,which is worth promoting.%目的:分析肾绞痛的患者的病因及观察肾绞痛患者的药物治疗疗效。方法:对2008年9月-2013年12月本院急诊外科的80例肾绞痛患者进行药物治疗,观察疗效情况。结果:肾绞痛患者97.5%系尿路结石引起,78例结石患者中,54例直径≤0.8 cm的患者肾绞痛症状明显缓解,平均药物治疗3~5 d后,肾积水解除,结石排出体外。结论:药物治疗结石直径≤0.8 cm的患者,方法简单,疗效可靠,值得推广。

  18. Comparing the analgesic effect of intravenous acetaminophen and morphine on patients with renal colic pain referring to the emergency department: A randomized controlled trial

    Reza Azizkhani

    2013-01-01

    Full Text Available Background: Kidney stone is normally treated by opioids with a variety of side-effects including hypotension, respiratory depression and apnea, nausea and vomiting. Regarding less complications of intravenous acetaminophen, we aimed to compare it with intravenous morphine in management of renal colic pain. Materials and Methods: A randomized controlled clinical trial was applied with a convenience sampling method, as 124 patients suffering from renal colic pain were randomly assigned into two groups of 62 patients. Pain was assessed using visual analog scale ruler. Results were analyzed by SPSS.18 using the descriptive statistic, Chi-square, ANOVA, independent t-test and logistic regression. Results: According to the findings, 84 subjects (67.7% were male. The mean age of participants were 39.06 (11.58. The mean of pain scores were not significantly different between two groups before administration of drugs (P = 0.415, while the more pain relief was achieved in morphine group after the intervention. Sex and age as influencing factors did not develop a significant difference in both groups. About the adverse effects, morphine had more complications and both groups showed a significant difference in occurrence of dizziness (P = 0.000 and hypotension (P = 0.014. Conclusion: Comparing intravenous morphine and acetaminophen in renal colic pain reviled that morphine can develop greater pain relief, but more complications such as dizziness and hypotension. Acetaminophen can be also be effective in renal colic pain, so it is concluded that acetaminophen can be administered as a less harmful drug for patients with renal colic pain.

  19. Utility of helical computed tomography in the management of renal colic; Utilidad de la tomografia computarizada helicoidal en el manejo del colico nefritico

    Martel, J.; Cruz, R. de la; Rengifo, D. [Fundacion Hospital Alcorcon. Madrid (Spain)

    2000-07-01

    In recent years, noncontrast helical computed tomography has modified the imaging techniques employed in the management of patients who arrive in the emergency service presenting signs of renal colic. Based on the literature and our own experience with 140 patients who complained of pain suggestive of a colic probably due to stone disease, we review the radiological features of this entity and discuss the utility of the technique in confirming the diagnosis, predicting the clinical course and detecting other diseases that present with identical symptomatology. (Author) 20 refs.

  20. Are there valid reasons for using anti-muscarinic drugs in the management of renal colic?

    Tomiak, R H; Barlow, R B; Smith, P J

    1985-10-01

    Experiments have been carried out with isolated ring preparations of human ureter. The tissue displayed spontaneous activity and contracted when exposed to barium chloride (0.5-4 mM) but no responses were obtained with carbachol (0.1 micromolar-0.1 mM). This raises questions about the value of treating ureteric colic with anti-muscarinic drugs. PMID:4063728

  1. Acute renal failure associated with nonfulminant acute viral hepatitis A

    Sarawgi, S.; Gupta, A. K.; Arora, D S; Jasuja, S.

    2008-01-01

    Hepatitis A runs a benign course in children, but may have atypical presentations in adults. Very rarely acute renal failure complicates nonfulminant hepatitis A. We report a patient with nonfulminant acute viral hepatitis A with multiorgan involvement. Patient had biopsy proven acute interstitial nephritis, acute pancreatitis, acute myocarditis and required hemodialysis for 6 weeks.

  2. Role of the plain radiograph and urinalysis in acute ureteric colic.

    Boyd, R.; A J Gray

    1996-01-01

    OBJECTIVE: (1) To determine the accuracy of accident and emergency (A&E) doctors' diagnosis of radio-opaque ureteric calculi on plain abdominal radiographs; (2) to study the predictive value of haematuria with a history suggestive of ureteric colic. DESIGN: A prospective study of all patients seen in a three month period with a provisional diagnosis of ureteric colic. Intravenous urography (IVU) was used as the gold standard for diagnosis of ureteric calculi. SETTING: The accident and emergen...

  3. Pain Relief for Acute Urolithiasis: The Case for Non-Steroidal Anti-Inflammatory Drugs.

    Steinberg, Peter L; Chang, Steven L

    2016-07-01

    Pain from renal colic is often severe and incapacitating. Many patients require emergent hospitalization and aggressive analgesia to relieve such discomfort. For many years, the optimal analgesic strategy has been sought to manage such severe pain. One of the mainstays of therapy for acute renal colic is with non-steroidal anti-inflammatory drugs (NSAIDs). This paper reviews the mechanism by which NSAIDs allow pain relief in renal colic, the evidence for their use in this condition, and the use of NSAIDs combined with other agents in renal colic. PMID:27286841

  4. Acute renal dysfunction in liver diseases

    2007-01-01

    Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (MRS) is a unique form of renal failure associated with advanced liver disease or cirrhosis, and is characterized by functional renal impairment without significant changes in renal histology. Irrespective of the type of renal failure, renal hypoperfusion is the central pathogenetic mechanism, due either to reduced perfusion pressure or increased renal vascular resistance. Volume expansion, avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment. Splanchnic vasoconstrictor agents, such as terlipressin, along with volume expansion, and early placement of transjugular intrahepatic portosystemic shunt (TIPS) may be effective in improving renal function in HRS. Continuous renal replacement therapy (CRRT) and molecular absorbent recirculating system (MARS) in selected patients may be life saving while awaiting liver transplantation.

  5. Is the KUB radiograph redundant for investigating acute ureteric colic in the non-contrast enhanced computed tomography era?

    Aim: To establish whether non-contrast enhanced computed tomography (NCCT) renders the kidneys-ureters-bladder (KUB) radiograph redundant as the initial imaging investigation for suspected acute ureteric colic. Materials and methods: The imaging investigations for 120 patients consecutively admitted to an emergency department-led clinical decisions unit (CDU) with suspected acute ureteric colic were retrospectively reviewed. A multidisciplinary meeting reviewed the findings and recommended that KUB radiographs should not be routinely performed prior to NCCT. Prospective assessment of 116 consecutive patients admitted over a comparable period was then undertaken. Results: In the retrospective group, 61 (50.8%) patients had calculi to account for symptoms (positive NCCT) and 59 (49.2%) patients did not have stone disease (negative NCCT). Ninety (75%) patients had a KUB radiograph prior to NCCT. However, in 46 (38% of total) of these patients the NCCT was negative for stones, and therefore, they had been subjected to an unnecessary radiographic examination. These results prompted a change in practice. In the subsequent and prospectively studied group, preliminary KUB radiographs were performed in only 6% of the patients, with no significant change in the positive NCCT rate (50.8 versus 51.7%) or the total number of examinations performed (120 versus 116). Conclusion: NCCT should be the initial imaging examination for acute ureteric colic. Up to 50% of patients with clinical suspicion do not have stone disease, and therefore, preliminary KUB radiographs with attendant radiation and cost implications are unjustified. Preliminary KUB radiographs can be omitted from the imaging pathway with no resultant indication creep or increase in demand for NCCT examinations

  6. Leptospirosis with acute renal failure and paraparesis

    Ramakrishna, P.; Sai Naresh, V. V.; Chakrapani, B.; B.Vengamma; Kumar, V. Siva

    2008-01-01

    Leptospirosis is an important zoonosis with a worldwide distribution that is characterized by a broad spectrum of clinical manifestations ranging from inapparent infection to fulminant disease. The presentation of paraparesis in combination with acute renal failure is rare.

  7. Exercise-induced acute renal failure and patchy renal vasoconstriction

    This paper evaluates the CT and MR findings and to understand the pathophysiology of kidneys in patients with acute renal failure accompanied by loin pain after participation in a track event. The authors obtained CT scan of the kidney enhanced by contrast material and 24- to 72-hour delayed scans without further use of contrast media were performed in all six patients with acute renal failure accompanied by severe loin pain after participation in a track event. MR imaging of the kidney was also performed in one patient. Five patients received analygensics

  8. Manejo del cólico renal en urgencias de un hospital de tercer nivel Nephritic colic management in an emergency room of a referral hospital

    M.A. Aibar-Arregui

    2010-08-01

    management of patients with nephritic colic in a referral hospital, their monitoring and the incidence of alternative diagnoses. Methods. This is a retrospective review of 182 randomly selected patients who presented a clinical diagnosis compatible with nephritic colic in a referral hospital. In these cases initial treatment, monitoring and alternative diagnoses have been evaluated. Results. Fifty-five point four percent of the patients were male, the mean age was 47.7 years and 40% of the cases were in spring. Urinalysis was carried out in every patient (62.7% dipstick and 72% urinary sediment; they were pathological in over 70%. In 26.4% of cases renal function deteriorated, always transiently. Abdominal radiography (81.9% was the most frequently diagnostic test performed, followed by ultrasound (25.8%. Treatment included a serum therapy in 31.3%; metamizol (61% was the most commonly used analgesic followed by ketorolac (44.5%. More than one non-steroidal anti-inflammatory was used by 46.2%. Hospital admission was required by 24 patients, and 5 of them needed emergency surgery. Twenty-four point one percent of patients had relapses during the next six months. Forty-one point six percent were referred to urology discharge on from the emergency room. Eighteen point one percent of patients had alternative diagnoses; acute pyelonephritis was the most frequent of these (55%. Conclusions. In our work we found a significant variation in the diagnostic and therapeutic management of these patients. The use of clinical guidelines could help us to unify the management of patients with nephritic colic, both in the emergency room and on discharge. Due to the high prevalence of alternative diagnoses, we have to systematically exclude more serious diseases.

  9. Prognostic factors in neonatal acute renal failure

    Sixteen infants, 2 to 35 days of age, had acute renal failure, a diagnosis based on serum creatinine concentrations greater than 1.5 mg/dL for at least 24 hours. Eight infants were oliguric (urine flow less than 1.0 mL/kg/h) whereas the remainder were nonoliguric. To determine clinical parameters useful in prognosis, urine flow rate, duration of anuria, peak serum creatinine, urea (BUN) concentration, and nuclide uptake by scintigraphy were correlated with recovery. Nine infants had acute renal failure secondary to perinatal asphyxia, three had acute renal failure as a result of congenital cardiovascular disease, and four had major renal anomalies. Four oliguric patients died: three of renal failure and one of heart failure. All nonoliguric infants survived with mean follow-up serum creatinine concentration of 0.8 +/- 0.5 (SD) mg/dL whereas that of oliguric survivors was 0.6 +/- 0.3 mg/dL. Peak serum creatinine concentration did not differ between those patients who were dying and those recovering. All infants who were dying remained anuric at least four days and revealed no renal uptake of nuclide. Eleven survivors were anuric three days or less, and renal perfusion was detectable by scintigraphy in each case. However, the remaining survivor (with bilateral renal vein thrombosis) recovered after 15 days of anuria despite nonvisualization of kidneys by scintigraphy. In neonates with ischemic acute renal failure, lack of oliguria and the presence of identifiable renal uptake of nuclide suggest a favorable prognosis

  10. : A Case of Acute Thromboembolic Renal Enfarction Associated with Paroxysmal Atrial Fibrillation

    Macit Kalcik; Mahmut Yesin; Lutfi Ocal; Taylan Akgun; Nursen Keles; Mustafa Ozan Gursoy; Mehmet Ozkan

    2014-06-01

    Full Text Available Infarction of the kidney is an uncommon condition that can result from obstruction or decrease of renal arterial flow. The diagnosis is often delayed because it can mimic many other pathologic states, including pyelonephritis, renal colic, acute abdomen, pancreatitis and more. A high index of suspicion is important for prompt diagnosis. We describe a 20-year-old man presented with abdominal and right flank pain and hematuria. A computed tomography scan with intravenous contrast showed partial infarction of right renal parenchyma and selective renal angiography showed complete occlusion of the right renal artery which was also supplied by an accessory renal artery. Electrocardiography showed normal sinus rhythm. Transthoracic and transesophageal echocardiographic findings were unremarkable except for mild spontaneous echo contrast (SEC in the left atrial appendage. Subsequent 48-hour holter monitorization revealed frequent premature atrial complexes and paroxysmal atrial fibrillation (PAF. Development of thromboembolic renal infarction was attributed to the presence of PAF and concurrent SEC in the left atrial appendage (LAA. Low molecular weight heparin(LMWH was followed by oral anticoagulant and an electrophysiologic study was planned for the management of PA

  11. Clinical management and analysis of renal colic in pregnancy%妊娠期肾绞痛的临床治疗及分析

    叶朝阳; 刘文刚; 李杰; 黎明

    2015-01-01

    目的:探讨妊娠期肾绞痛患者的临床治疗特点,总结临床经验。方法分析2010年6月~2012年6月因肾绞痛就诊于我院泌尿外科的49例妊娠期患者的临床资料。结果其中15例保守治疗后肾绞痛缓解。29例置入输尿管D-J管,3例行输尿管镜下钬激光碎石,2例行经皮肾造瘘术,所有妊娠期患者均顺利分娩。结论妊娠期肾绞痛的患者首选保守治疗,对于顽固性肾绞痛患者,外科治疗首选逆行插管引流尿液,必要时可选择输尿管镜检查或经皮肾穿刺。%Objective To analyze the clinical features of renal colic during pregnancy of renal colic during pregnancy. Methods A total of 49 pregnant women admitted into our hospital for renal colic from June 2010 to June 2012 were retrospectively analyzed. Results 15 patients underwent medicine therapy successfully. 29 cases underwent double J stents, 3 cases underwent holmium laser lithotripsy through ureteropyeloscopy, and 2 cases underwent percutaneous nephrostomy. 49 cases experienced full term pregnancy were likely to end in a lie birth. Conclusion For the pregnant women complicating with upper urinary tract calculi, medicine therapy is the preliminary consideration. The double J stents inserting, the percutaneous nephrostomy, and urteroscopy are safety choices.

  12. Effect of phloroglucinol on the treatment of renal colic during pregnancy%间苯三酚治疗妊娠期肾绞痛疗效观察

    莫旻龙; 石崛

    2011-01-01

    Objective:To evaluate the effect of phloroglucinol on treatment of renal colic during pregnancy. Method:21 cases of renal colic stones during pregnancy were randomly divided into treatment group and control group, which received intravenous infusion of phloroglucinol or anisodamine, respectively. Analgesic effect, recurrence rate and adverse reactions were compared between the two groups. Result:The analgesic effect of the treatment group total effective rate was higher than that of in the control group (90. 90% vs 70. 00% ,P<0. 05). Compared to control group, relapse rate was lower in treatment group (18. 18% vs 50. 00%). Pain between the two groups and the total effective rate of relapse was significantly different. Treatment group did not show adverse reaction. 2 cases of recurrence renal colic often were treated with ureteral microscopically ballistic lithoclast. Conclusion:Compared with anisodamine, phloroglucinol intravenous treatment during pregnancy is effective for renal colic pain has not adverse reactions.%目的:评价间苯三酚在妊娠期肾绞痛中的应用.方法:将21例妊娠期结石性肾绞痛患者随机分成两组,治疗组静脉滴注间苯三酚,对照组静脉滴注山莨菪碱.同时联合硫酸镁,黄体酮治疗.观察组间止痛效果,复发率及不良反应.结果:止痛效果:治疗组(间苯三酚)总有效率为90.90%,对照组(山莨菪碱)为70.00%;复发率:前者18.18%,后者50.00%.组间比较止痛总有效率及复发率差异均有统计学意义(P<0.05).治疗组(间苯三酚)未见不良反应.2例肾绞痛频繁发作者予输尿管镜下弹道碎石术渐缓解.结论:相比山莨菪碱,静脉应用间苯三酚治疗妊娠期肾绞痛镇痛效果肯定、能有效安胎且无明显不良反应.

  13. A rare case of recurrent urinary obstruction and acute renal failure from cystitis cystica et glandularis

    Zhu, Justin X.G.; Gabril, Manal Y; Sener, Alp

    2012-01-01

    We report a rare case of recurrent florid cystitis cystica et glandularis (CCEG), common type, causing obstruction of the left ureterovesicle junction (UVJ) leading to renal colic and hydronephrosis. A 43-year-old man was admitted with renal colic, left UVJ obstruction, left hydronephrosis and azotemia. Cystoscopy showed a >4-cm bladder lesion compressing the left UVJ. Transurethral resection of the bladder tumour (TURBT) was performed and pathology revealed the lesion as CCEG. Two months lat...

  14. Clinical Practice Guidelines for Acute Renal Failure.

    Argelio Alberto Santana Cano; Marta Patricia Casanova González; Belkys Rodríguez Llerena.; Eddy Pereira Valdés

    2009-01-01

    Clinical Practice Guidelines for Acute Renal Failure. It a syndrome characterized by the abrupt deterioration of basal renal functions (abrupt reduction of glomerular filtration) and the consequent increase of nitrogenous products in the blood as well as the homeostasis of the body. It aetiological agents, clinical presentation, therapeutic and diagnostic methods are described. It includes assessment guidelines focused on the most important aspects to be accomplished.

  15. Clinical Practice Guidelines for Acute Renal Failure.

    Argelio Alberto Santana Cano

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Acute Renal Failure. It a syndrome characterized by the abrupt deterioration of basal renal functions (abrupt reduction of glomerular filtration and the consequent increase of nitrogenous products in the blood as well as the homeostasis of the body. It aetiological agents, clinical presentation, therapeutic and diagnostic methods are described. It includes assessment guidelines focused on the most important aspects to be accomplished.

  16. Acute appendicitis mistaken as acute rejection in renal transplant recipients.

    Talwalkar N; Javali D; Venkatesh K; Iyer S; Venkatesh M; Joshi U

    1994-01-01

    Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in...

  17. Acute renal failure due to ciprofloxacin.

    Allon, M; Lopez, E J; Min, K W

    1990-10-01

    Acute renal failure developed in three patients within a few days of starting ciprofloxacin hydrochloride therapy. An allergic interstitial nephritis was suggested by fever and eosinophiluria in one patient and by erythema multiforme in another. A kidney biopsy specimen confirmed this diagnosis in one patient. Renal function improved shortly after withdrawal of the drug in all three patients. Literature survey revealed an additional three patients with a similar complication. Allergic manifestations, such as fever or rash, were a feature in most reported cases. In view of this potential complication, renal function should be closely monitored in patients receiving ciprofloxacin therapy, especially if other potentially nephrotoxic drugs are prescribed concomitantly. PMID:2222106

  18. Clinical Observation of Diagnosis and Treatment of Renal Colic During Pregnancy%妊娠期肾绞痛的临床特点及诊治分析

    符浩; 宋汶珂

    2012-01-01

    目的 观察妊娠期肾绞痛的临床特点,探讨妊娠期肾绞痛有效、安全的诊断和治疗方法.方法 回顾性分析2006年6月-2011年3月在我院就诊的46例妊娠期肾绞痛患者的临床资料,给予所有患者对症保守治疗,对于保守治疗无效者采取外科治疗.结果 本组46例患者先行保守治疗,其中37例治疗有效,23例排出结石;9例经保守治疗无效,行输尿管镜下内支架管置入术,患者疼痛迅速缓解.所有患者产后3个月行彩色多普勒超声复查显示患肾恢复良好、积水减少或消失,仅3例有轻度积水.结论 对于妊娠期肾绞痛的患者,泌尿系结石多见,彩色多普勒超声检查为首选,磁共振泌尿系水成像检查是理想的检查方法.妊娠期肾绞痛绝大部分保守治疗有效,对保守治疗无效的患者在局麻下应用输尿管镜下置入内支架管能有效缓解肾绞痛,是安全和有效的外科治疗方法.%Objective To analyze the clinical features of renal colic in pregnant patients and to evaluate efficacious and safe methods for the diagnosis and treatment of renal colic in pregnancy. Methods Clinical data of 46 pregnant patients with renal colic admitted to our hospital from June 2006 to March 2011 were retrospectively analyzed. All patients were given symptomatic conservative treatment, and surgical treatment was given to those who failed to respond to conservative treatment. Results All patients were treated by conservative therapy in the first place. 37 cases had remarkably effective outcome, 23 cases had expulsion of stones. 9 cases failed to respond to conservative therapy, but their pain was relieved after the placement of uretal stent with ureteroscopic. All patients were reexamined by color Doppler echocardiography three month after childbirth. The renal recover-y was obvious in all cases and hydronephrosis was reduced or disappeared. Only 3 cases had mild hydronephrosis. Conclusion U-rinary calculus is commonly

  19. Acute renal failure in rats

    It was demonstrated in rats that renal injury which follows transient renal hypoxia is potentiated by the contrast media metrizoate, ioxaglate, iopamidol and iohexol. Intravenous injection of 1 g I/kg of all four media alone to 82 rats caused no significant increase in serum urea 1, 3 and 7 days later. The percentage increase of serum urea is given in median values and interquartile range (in parentheses). Bilateral renal arterial occlusion alone for 40 minutes in 42 rats increased serum urea one day later by 40% (20-130). Intravenous injection of the media followed in one hour by bilateral renal arterial occlusion for 40 minutes in 104 rats caused serum urea to increase one day later by 130% (70-350) after metrizoate, by 220% (50-380) after ioxaglate, by 290 % (60-420) after iopamidol and by 160% (50-330) after iohexol. There were no significant differences between the potentiating effects of the various media on ischemic renal failure. (orig.)

  20. 针灸治疗肾绞痛近年概况%Acupuncture in the treatment of renal colic recent years situation

    刘佳琳; 胡亚才; 李会娟; 李桂平

    2015-01-01

    Understanding in recent years in the clinical application of acupuncture in the treatment of renal colic and its mechanism of action. Search word “renal colic” and “acupuncture” & “needle” as a keyword or keywords for document retrieval (CNKI,VIP,ten thousand,January 1,2008 on December 10,2014),after picking, the results of the retrieved related with 55 references,ncluding 17,body acupuncture point injection 8,article PingHengZhen five articles,including 2, plum needle tired down, 2 wrist ankle needle 1 piece, acupuncture cooperate earpins 3 article,earpins,2 needle medicine combined with four chapters, the other 4 piece, experimental research on seven articles. Literature induction shows that acupuncture and moxibustion treatment of the disease,rapid and lasting analgesic effects, and the simple, economic,safety and no side effects, clinical curative effect,Must be further studied its mechanism.

  1. Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic

    Ather M Hammad

    2003-03-01

    Full Text Available Abstract Background Patients presenting in the emergency room with flank pain suggestive of acute ureteric colic may have alternative underlying conditions mimicking ureteric stones. An early diagnosis and appropriate treatment for other causes of flank pain is important. The majority of centers around the world are increasingly using un-enhanced helical CT (UHCT for evaluation of ureteric colic. This study was conducted to determine the incidence and spectrum of significant incidental diagnoses established or suggested on UHCT performed for suspected renal/ureteric colic. Methods Urologist and radiologist reviewed 233 consecutive UHCT, performed for suspected renal/ureteral colic along with assessment of the medical records. Radiological diagnoses of clinical entities not suspected otherwise were analyzed. All other relevant radiological, biochemical and serological investigations and per-operative findings were also noted. Results Ureteral calculi were identified in 148 examinations (64%, findings of recent passage of calculi in 10 (4% and no calculus in 75 examinations (32%. Overall the incidental findings (additional or alternative diagnosis were found in 28 (12% CT scans. Twenty (71% of these diagnoses were confirmed by per-operative findings, biopsy, and other radiological and biochemical investigations or on clinical follow up. Conclusion A wide spectrum of significant incidental diagnoses can be identified on UHCT performed for suspected renal/ureteral colic. In the present series of 233 consecutive CT examinations, the incidence of incidental diagnosis was 12%.

  2. Renal replacement therapy in sepsis-induced acute renal failure

    Rajapakse Senaka

    2009-01-01

    Full Text Available Acute renal failure (ARF is a common complication of sepsis and carries a high mortality. Renal replacement therapy (RRT during the acute stage is the mainstay of therapy. Va-rious modalities of RRT are available. Continuous RRT using convective methods are preferred in sepsis-induced ARF, especially in hemodynamically unstable patients, although clear evidence of benefit over intermittent hemodialysis is still not available. Peritoneal dialysis is clearly inferior, and is not recommended. Early initiation of RRT is probably advantageous, although the optimal timing of dialysis is yet unknown. Higher doses of RRT are more likely to be beneficial. Use of bio-compatible membranes and bicarbonate buffer in the dialysate are preferred. Anticoagulation during dialysis must be carefully adjusted and monitored.

  3. Elderly patient with ureteric colic: suspect leaking aneurysm

    Sinha, Yashashwi

    2013-01-01

    Described below is a case of a 72-year-old man with an abdominal aortic aneurysm (AAA) presenting with symptoms of renal colic. This case illustrates the hazards of making a diagnosis of renal colic in an elderly patient without considering the diagnosis of a leaking AAA. The diagnosis of an AAA can be challenging and renal colic is the single most common misdiagnosis. The patient's initial presentation can be misleading as symptoms fit the features of renal colic or a leaking AAA. Despite no...

  4. Acute Renal Failure in a Renal Center, Iraq

    We evaluated retrospectively the etiology and outcome of acute renal failure (ARF) in 84 patients in Rasheed Renal Center in Baghdad, Iraq from June 1998 through March 1999. They were 82 males and 2 females with ages that ranged between 5 and 80 years. Prerenal ARF was the commonest type found in 45 (53.6%) patients followed by renal ARF in 33 (39.3%) patients and acute obstructive uropathy six (7.1%) patients. Clinically, 74 patients presented with oligo-anuria, while 10 patients presented with non-oliguria. Of the oligo-anuria group, 61 ( 82.4%) patients required required renal replacement therapy (RRT) and 50 (67.6%) had complete recovery. The mortality rate was 25.67% in the oliguric group, while none in the non-oliguric group required RRT and the complete recvery rate was 100%. The overall survival in both groups was (77.4%). The patterns of ARF in our center were mostly compatible with the previous reports from the region. (author)

  5. Nuclear medicine in acute and chronic renal failure

    The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131I OIH, 67gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease

  6. Acute appendicitis mistaken as acute rejection in renal transplant recipients.

    Talwalkar N

    1994-01-01

    Full Text Available Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in patient with such presentation; otherwise wrong treatment may be received.

  7. 妊娠期肾绞痛治疗方法的选择%Modalities of treatment of renal colic in pregnancy

    赵小磊; 徐文超; 谢青南; 杜信毅; 李铁强

    2008-01-01

    目的 探讨妊娠期肾绞痛中不同治疗方法的效果和顽固性肾绞痛输尿管镜应用的价值.方法 42例妊娠期肾绞痛患者,首先选择休息、大量补充水、止痛、解痉、抗感染等保守治疗;无效者应用输尿管镜检查和治疗16例,放置D-J管;如置管失败,再行输尿管镜探查和碎石.结果 保守治疗26例;输尿管镜留置D-J管成功10例,并定期更换D-J管8例;妊娠期气压弹道碎石并留置D-J管6例,其中5例成功.1~2周后拔出D-J管.产后输尿管镜碎石和体外震波碎石8例.结论 保守治疗多数病例疼痛可完全缓解作为首选,应严密随访;对反复发作和顽固性肾绞痛患者,先考虑留置D-J管,尽量减少对患者刺激,以避免流产和先兆流产;必要时再行输尿管镜检查和气压弹道碎石.%Objective To discuss our experience with initial treatment in management of renal colic with or without urreteral stones in pregnant women.Methods Forty-two women with pregnancy were proved to have renal colic.Conservative treatment with hydration,analgesics and antibiotics were primarily applied.16 cases then received minimally invasive procedures,including double J-stenting and ureteroscopy,if primary treanment failed.Result Twenty-six cases got well with conservative therapies.Other 16 needed further minimally invaisve procedures,including 10 D-J stenting and 6 ureteroscopy with pneumatic lithotripsy,D-J stenting was withdrawn within 1 to 2 weeks operation.Conclusion If recurrent renal colic or failed,minimally invasive procedures of D-J stenting or further uretreoscopic pneumatic lithotripsy can facilitate the successful management of remaining cases without abortion.

  8. Acute dengue myositis with rhabdomyolysis and acute renal failure

    Acharya Sourya

    2010-01-01

    Full Text Available Dengue is an acute mosquito-borne infection caused by dengue viruses from the genus flavivirus. Neurologic complications have been attributed chiefly to metabolic alterations and to focal and sometimes massive intracranial haemorrhages, but anecdotal cases and limited case series have indicated the possibility of viral CNS and skeletal muscle invasion causing encephalitis and myositis. We present a case of a 40-year-old male who presented with severe dengue myositis resulting in quadriparesis, respiratory failure and acute renal failure with red urine. His elevated serum creatine kinase (CK, serum and urine myoglobin levels justified rhabdomyolysis as the cause of acute renal failure. A muscle biopsy revealed inflammatory myositis. He required ventilator support for respiratory failure and was treated conservatively. This case highlights the severe and persistent muscle involvement in dengue which is a rarity.

  9. Acute Renal Failure and the Critically Ill Surgical Patient

    Sykes, Eliot; Cosgrove, Joseph F

    2007-01-01

    Acute renal failure can occur following major surgery. Predisposing factors include massive haemorrhage, sepsis, diabetes, hypertension, cardiac disease, peripheral vascular disease, chronic renal impairment and age. Understanding epidemiology, aetiology and pathophysiology can aid effective diagnosis and management. A consensus definition for acute renal failure has recently been developed. It relates to deteriorating urine output, serum creatinine and glomerular filtration rate. In the surg...

  10. Acute renal failure secondary to rhabdomyolysis

    MR imaging of the kidney was performed in 6 patients with acute renal failure (ARF) secondary to rhabdomyolysis caused by snake bite (n = 4), crush injury (n = 1), and carbon monoxide poisoning (n = 1). A test for urine myoglobin was positive in all 6 patients and MR imaging was done 6 to 18 days after the causative event of the rhabdomyolysis. MR images in all 6 patients showed globular swelling of the kidneys, preserved corticomedullary contrast on T1-weighted images, and obliteration of corticomedullary contrast on T2-weighted images. Unlike other medical renal diseases in which corticomedullary contrast is lost on T1-weighted images, preservation of the corticomedullary contrast on T1-weighted MR images with globular renal swelling was a constant finding in patients with ARF secondary to rhabdomyolysis. (orig.)

  11. Acute renal failure due to rhabdomyolyisis

    Nieto-Ríos, John Fredy

    2016-04-01

    Full Text Available Acute renal failure is a frequent cause of morbidity and mortality in emergency, hospitalization and critical care services. In 15 % of cases it is due to rhabdomyolysis, in which there is breakdown of skeletal muscle with massive necrosis and leakage of muscle cell contents into the circulation. It has many different etiologies. The rhabdomyolysis-induced acute kidney injury results from the combination of several mechanisms, including tubular obstruction, vasoconstriction and oxidative stress. The most important therapeutic measures are: Aggressive repletion of fluids, forced diuresis and avoidance of exposure to nephrotoxic substances. In cases of severe uremia, metabolic acidosis, hiperkalemia or fluid overload it is necessary to start renal replacement therapy. As a rule, kidney function is completely recovered, but these patients have higher risk of future chronic kidney disease.

  12. Managing acute and chronic renal stone disease.

    Moran, Conor P; Courtney, Aisling E

    2016-02-01

    Nephrolithiasis, or renal stone disease, is common and the incidence is increasing globally. In the UK the lifetime risk is estimated to be 8-10%. On a population level, the increase in stone incidence, erosion of gender disparity, and younger age of onset is likely to reflect increasing prevalence of obesity and a Western diet with a high intake of animal protein and salt. Stones can be detected by a variety of imaging techniques. The gold standard is a non-contrast CT of kidneys, ureters and bladder (CT KUB) which can identify > 99% of stones. CT KUB should be the primary mode of imaging for all patients with colic unless contraindicated. In such instances, or if a CT KUB is not available, an ultrasound KUB is an alternative. This has advantages in terms of radiation exposure and cost, but is limited in sensitivity, particularly for ureteric stones. Once diagnosed, a plain film KUB can be used for follow-up of radiopaque stones. For most patients diclofenac is a reasonable first choice of analgesia, e.g. 50-100 mg rectally, or 75 mg IM. Opioid medication can worsen nausea and be less effective, but should be used if there is a contraindication to NSAIDs. A combination of diclofenac, paracetamol, and/or codeine regularly can provide adequate pain control in many cases. Failure of this analgesic combination should prompt consideration of secondary care support. If a ureteric stone 10 mm in diameter should be discussed with the urology service as they are unlikely to pass spontaneously. PMID:27032222

  13. 妊娠期肾绞痛的输尿管镜治疗%The emergency ureteroscopic treatment of renal colic during pregnancy

    朵永福; 刘国庆; 李杰荣; 王剑锋; 陈一平; 黄振强; 郑锦涛

    2013-01-01

    [Objective] To explore the effect of ureteroscopic treatment of renal colic during pregnancy.[Method] From October 2007 to October 2011,259 cases of pregnant women with renal colic,161 cases (gestational 13-38weeks,mean 24.67 weeks) accepted ureteroscopic treatment for expectant treatments without effectiveness were treated.[Results] Calculi were found in 139 case,43 cases' calculi were located in upper ureter.87 cases' in lower ureter,and 9 cases' in upper ureter of both sides,the ureteric calculi were 0.5~2.3 cm in dimension; In 136 cases,colic disappeared in 24 hours.Symptoms disappeared in 24~72 hour in the other 3 cases.28 cases had transient gross hematuria,12 cases had fever,placed double-J tubes for 2~12 week.No case of ureter injury occurred.Pregnancy outcome:4cases were spontaneous abort,5 cases were premature delivery,27 cases were abdominal delivery and 103 cases were vaginal delivery.[Conclusion] Ureteroscopic treatment of renal colic during pregnancy can reduce dose of medicine,relief pains in abdomen and lumbus,protect renal function and development of fetus.%目的 探讨输尿管镜技术在妊娠肾绞痛治疗中的意义.方法 2007年10月~2011年10月收治妊娠肾绞痛患者259例,161例因保守治疗无效接受输尿管镜治疗,孕周13~38周,平均24.67周.结果139例发现结石,其中输尿管上段结石43例、下段结石87例、双侧上段结石9例,结石大小0.5~2.3 cm,术后24 h肾绞痛症状消失者136例,其余3例术后24 ~ 72 h疼痛症状缓解,短期肉眼血尿28例,发热12例,留置输尿管双J管2~12周,无输尿管穿孔与损伤;随访妊娠情况:流产4例、早产5例、剖宫产27例、经阴道产103例,无胎儿畸形及发育异常.结论 输尿管镜治疗妊娠期肾绞痛,具有减少解痉镇痛用药量、快速引流尿液、缓解腰腹疼痛、保护患肾功能、保障母胎发育的特点,术中适当应用气压弹道或超声碎石是安全的.

  14. The prospective study of emergency therapeutic methods for renal colic%肾绞痛急诊治疗方法的前瞻性研究

    徐志锋; 何纲; 李志全; 陈荣健; 李国明

    2012-01-01

    目的 通过对几种急性肾绞痛治疗方法的效果进行对比分析,探讨急诊科治疗肾绞痛的首选方法.方法 选取急诊科340例肾绞痛患者,按就诊顺序随机分为4组:A(哌替啶)组;B(双氯芬酸钠)组;C(间苯三酚)组;D(双氯芬酸钠+间苯三酚)组.观察各组的平均起效时间及用药30min后的疗效.结果 哌替啶组、双氯芬酸钠+间苯三酚组、双氯芬酸钠组的平均起效时间分别为(9.53±3.34)min、(10.49±2.54) min、(10.51±2.27)min,均少于间苯三酚组(18.51±4.86) min,差异有统计学意义(P<0.01);而前三者间差异无统计学意义(P>0.05).4组的有效率差异无统计学意义(P>0.05).复发率比较,间苯三酚组(11.43%)和双氯芬酸钠+间苯三酚组(9.00%)均低于哌替啶组(24.59%)和双氯芬酸钠组(23.75%).间苯三酚组无不良反应,双氯芬酸钠组和双氯芬酸钠+间苯三酚组的不良反应率(2.27%、2.78%)均低于哌替啶组(27.27%).结论 双氯芬酸钠+间苯三酚是目前值得推荐的肾绞痛治疗方法.%Objective To analyze and compare the emergency therapeutic methods for renal colic,and to explore the preferable way of emergency therapies for renal colic.Methods A total of 340 cases of renal colic in emergency department were randomly divided into groups A (pethidine),B (diclofenac sodium),C (phloroglucinol),and D (diclofenac sodium + phloroglucino).The average time of therapeutic effect after given 30 min in different groups was observed.Results The average time of effect in group A [(9.53 ±3.34) min],group D[(10.49 ±2.54) min],and group B[(10.51 ±2.27)min] and they were much shorter than group C [(18.51 ±4.86) min] (P <0.01).There was no significant difference in the effective rate among the 4 groups(P > 0.05).The relapse rate of group C (11.43%) and group D (9.00%) were much lower than group A (24.59%) and group B(23.75%).There was no adverse reaction in group C.The rates of adverse reactions in

  15. 妊娠期肾绞痛的临床治疗96例报告%Treatment of renal colic during pregnancy (report of 96 cases)

    贺凯; 袁光亚; 何苑熙; 王耀东

    2012-01-01

    目的 探讨妊娠期肾绞痛安全、有效的治疗方法.方法 回顾性分析96例妊娠期肾绞痛患者的临床资料和治疗方法.结果 初次发病者中33例首先行保守治疗症状消失,另外18例经外科手段治疗而愈,45例非初次发病患者直接经外科手段治疗症状消失,96例无1例出现产科意外及手术并发症.结论 初次发作肾绞痛患者可先采取保守治疗,非初次发作患者或输尿管结石直径>0.5cm患者应选择外科手段治疗.%Objective To evaluate the safe and effective management for renal colic in pregnancy. Methods 96 cases of renal colic in pregnancy were retrospectively analysed in treatment and prognosis. Results All cases were cured and none cases occurred complications in surgery and pregnancy. 33 cases who broke out pain for the first time were treated in conservative way and the other 18 caseswere treated in surgical way. Another 45 cases who brokeout pain repeatedly were treated in surgical way directly. Conclusion Patients who broke out pain for the first time could choose conservative therapy first and patientsbroke out pain repeatedly or caculi in ureter > 0.5cm should choose surgical therapy for first.

  16. Acute renal failure in children. An ultrasonographic-clinical study

    Vergesslich, K.A.; Balzar, E.; Weninger, M.; Ponhold, W.; Sommer, G.; Wittich, G.R.

    1987-11-01

    Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% +- 1.40 S.D.) and group B (5.95 mg% +- 1.96 S.D.), p < 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. (orig.)

  17. Tsutsugamushi infection-associated acute rhabdomyolysis and acute renal failure.

    Young, Park Chi; Hae, Chung Choon; Lee, Kim Hyun; Hoon, Chung Jong

    2003-12-01

    Rhabdomyolysis is a rare complication that emerges in a variety of infectious diseases, such as tsutsugamushi infection. In this study, we report a 71-year-old female patient with tsutsugamushi infection who exhibiting rhabdomyolysis and acute renal failure. On admission, an eschar, which is characteristic of tsutsugamushi infection, was found on her right flank area. Moreover, her tsutsugamushi antibody titer was 1:40960. The elevated values of serum creatinine phosphokinase (CPK), aldolase, creatinine and dark brown urine secondary to myoglobinuria are consistent with indications of rhabdomyolysis and acute renal failure due to tsutsugamushi infection. Her health improved without any residual effects after treatment with doxycyclin and hydration with normal saline. PMID:14717236

  18. Tsutsugamushi Infection-Associated Acute Rhabdomyolysis and Acute Renal Failure

    Young, Park Chi; Hae, Chung Choon; Lee, Kim Hyun; Hoon, Chung Jong

    2003-01-01

    Rhabdomyolysis is a rare complication that emerges in a variety of infectious diseases, such as tsutsugamushi infection. In this study, we report a 71-year-old female patient with tsutsugamushi infection who exhibiting rhabdomyolysis and acute renal failure. On admission, an eschar, which is characteristic of tsutsugamushi infection, was found on her right flank area. Moreover, her tsutsugamushi antibody titer was 1:40960. The elevated values of serum creatinine phosphokinase (CPK), aldolase,...

  19. Acute renal failure caused by contrast media

    Acute renal complications occurring in response to intravascular administration of iodinated contrast media may remain restricted to clinically irrelevant, transient elevations of serum creatinine, but just as well manifest themselves in the form of severe oliguric renal failure giving rise to the need of life-long hemodialysis. It was the aim of this study to determine the frequency of those renal hazards by a) systematic screening of the literature for relevant cases and b) retrospective and prospective examination of patients chosen by the author. The mean frequency of incidents determined on the basis of data from the relevant literature was 5% for non-stratified populations. A separate analysis of no risk patients showed this to be as low as 0.5%. In a prospective study of 69 patients receiving the non-ionic contrast medium Iopamidol, for the purposes of phlebography, serum creatinine determinations carried out at 24 and 48 hours did in no case reveal increases exceeding 25%, even though 11 patients of this cohort were at a particular risk of developing renal complications. The remote possibility of nephrophaty occurring as a result of contrast medium administration could be further reduced by the use of non-ionic materials. (orig./GDG)

  20. Acute renal dysfunction following hip fracture.

    Bennet, Simon J; Berry, Olivia M B; Goddard, Jane; Keating, John F

    2010-04-01

    We investigated the incidence, risk factors and outcome of acute renal dysfunction (ARD) in patients with a fractured neck of femur. 170 consecutive patients were prospectively included in the Scottish Hip Fracture Audit database and retrospectively analysed. Historically, lack of consensus definition has hindered accurate reporting of ARD. ARD was defined using the 'RIFLE' criteria. 27 patients (16%) developed ARD. Risk factors were male sex, vascular disease, hypertension, diabetes, chronic kidney disease and pre-morbid use of nephrotoxic medications (pARD group 19%, 22% and 41% respectively, versus 0%, 4% and 13% in the non-ARD group (pARD group. Pre- and post-operative complications were 12 and 5 times more frequent respectively in the ARD group (p<0.01). Awareness of risk factors and serial measurements of renal function allow early identification and focused monitoring of these patients. PMID:19729159

  1. Rhabdomyolysis and Acute Renal Failure after Gardening

    Zeljko Vucicevic

    2015-01-01

    Full Text Available Acute nontraumatic exertional rhabdomyolysis may arise when the energy supply to muscle is insufficient to meet demands, particularly in physically untrained individuals. We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and consecutive acute renal failure following excessive work in the garden. Although specifically asked, the patient denied any hard physical work or gardening, and heteroanamnestic data were not available. The diagnosis of rhabdomyolysis was easy to establish, but until reliable anamnestic data were obtained, the etiology remained uncertain. Four days after arrival, the patient recalled working hard in the garden. The etiology of rhabdomyolysis was finally reached, and the importance of anamnestic data was once more confirmed.

  2. Rhabdomyolysis and acute renal failure after gardening.

    Vucicevic, Zeljko

    2015-01-01

    Acute nontraumatic exertional rhabdomyolysis may arise when the energy supply to muscle is insufficient to meet demands, particularly in physically untrained individuals. We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and consecutive acute renal failure following excessive work in the garden. Although specifically asked, the patient denied any hard physical work or gardening, and heteroanamnestic data were not available. The diagnosis of rhabdomyolysis was easy to establish, but until reliable anamnestic data were obtained, the etiology remained uncertain. Four days after arrival, the patient recalled working hard in the garden. The etiology of rhabdomyolysis was finally reached, and the importance of anamnestic data was once more confirmed. PMID:25954536

  3. 间苯三酚注射液治疗肾绞痛的临床疗效及不良反应观察%Clinical Effect and Side Effect of Phloroglucinol Injection Treating Renal Colic

    王伟炳; 朱华军

    2013-01-01

    [Objective] To evaluate the efficacy and the safety of phloroglucinol in the treatment of renal colic. [Methods] One hundred and twenty-five patients with renal colic were divided into two groups randomly with the treatment of phloroglucinol injection(80mg) and anisodamine injection(lOmg) resepectively.At 30 minutes after administration,the efficacy of two groups was analyzed as well as the side effects. [Results] The efficacy rate in phlorogluci-nol group was 89.3% ,and that in anisodamine group was 82.0% . There was a statistical difference between the two groups.Side effects occurred in 5.3% cases in phloroglucinol group while those occurred in 84.0% cases in anisodamine group. There was significant statistical difference between two groups. [Conclusions] Phloroglucinol is safe and effective in the treatment of renal colic.%[目的]评价间苯三酚注射液治疗肾绞痛(renal colic,RC)的疗效及安全性.[方法]125例RC患者随机分为治疗组和对照组,分别给予间苯三酚(80mg)、山莨菪碱针(10mg)静脉滴注(ivgtt),观察用药30min后效果,比较两组治疗后的疗效和不良反应.[结果]两组总有效率分别为89.30%和82.00%,治疗组效果明显优于对照组(P<0.05);不良反应发生率分别为5.33%和84.00%,两组比较有显著性差异(P<0.01).[结论]间苯三酚治疗PC疗效确切,安全性好.

  4. Ureteroscopic Holmium Laser Lithotripsy for the Ureter Stones with Renal Colic in Emergency%急诊输尿管镜钬激光碎石治疗输尿管结石致肾绞痛

    杨勇; 陈祥; 涂建民

    2009-01-01

    目的:探讨急诊输尿管镜下钬激光碎石术治疗输尿管结石并发肾绞痛的疗效.方法:对76例因输尿管结石并发肾绞痛患者,采用输尿管镜下钬激光碎石术.结果:2例因结石上移至肾盂,2例因输尿管下段狭窄使输尿管无法到达结石部位手术失败,其余72例均碎石成功,术后当天肾绞痛缓解.碎石成功率为94.7%,术后肾绞痛缓解率为97.4%.结论:输尿管镜下钬激光碎石术治疗输尿管结石引起的肾绞痛,是一种安全、有效的方法.%Objective: To evaluate the clinical efficacy of ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculi with renal colic in emergency. Method: A total of 76 cases of ureteral calculi with renal colic were treated by ureteroscopic holmium laser lithotripsy. Result: Successful lithotripsy was achieved in 72 cases, two cases failed due to movement of calculus to pelvis and another two failed because of ureterostenosis at inferior segment. The successful rate of lithotripsy was 94.7%, The relief rate of renal colic was 97.4%. Conclusion: Ureteroscopic holmium laser lithotripsy is an effective and safe method for the treatment of ureteral calculi with renal colic.

  5. Acute renal infarction Secondary to Atrial Fibrillation Mimicking Renal Stone Picture

    Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as renal stone. Further investigations confirmed her as a case of renal infarction. Renal infarction is under-diagnosed because the similarity of its presentation to renal stone. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation. (author)

  6. Acute renal failure in Yemeni patients

    Muhamed Al Rohani

    2011-01-01

    Full Text Available Acute renal failure (ARF is defined as a rapid decrease in the glomerular filtration rate, occurring over a period of hours to days. The Science and Technology University Hospital, Sana′a, is a referral hospital that caters to patients from all parts of Yemen. The aim of this study is to have a deeper overview about the epidemiological status of ARF in Yemeni patients and to identify the major causes of ARF in this country. We studied 203 patients with ARF over a period of 24 months. We found that tropical infectious diseases constituted the major causes of ARF, seen in 45.3% of the patients. Malaria was the most important and dominant infectious disease causing ARF. Hypotension secondary to infection or cardiac failure was seen in 28.6% of the patients. Obstructive nephropathy due to urolithiasis or prostate enlargement was the cause of ARF in a small number of patients. ARF was a part of multi-organ failure in 19.7% of the patients, and was accompanied by a high mortality rate. Majority of the patients were managed conservatively, and only 39.9% required dialysis. Our study suggests that early detection of renal failure helps improve the outcome and return of renal function to normal. Mortality was high in patients with malaria and in those with associated hepatocellular failure.

  7. Unenhanced spiral CT in acute ureteral colic: a replacement for excretory urography?

    To compare the usefulness of unenhanced spiral CT (UCT) with that of excretory urography (EU) in patients with acute flank pain. Thirty patients presenting with acute flank pain underwent both UCT and EU. Both techniques were used to determine the presence, size, and location of urinary stone, and the presence or absence of secondary signs was also evaluated. The existence of ureteral stone was confirmed by its removal or spontaneous passage during follow-up. The absence of a stone was determined on the basis of the clinical and radiological evidence. Twenty-one of the 30 patients had one or more ureteral stones and nine had no stone. CT depicted 22 of 23 calculi in the 21 patients with a stone, and no calculus in all nine without a stone. The sensitivity and specificity of UCT were 96% and 100%, respectively. EU disclosed 14 calculi in the 21 patients with a stone and no calculus in eight of the nine without a stone. UCT and EU demonstrated secondary signs of ureterolithiasis in 15 and 17 patients, respectively. For the evaluation of patients with acute flank pain, UCT is an excellent modality with high sensitivity and specificity. In near future it may replace EU

  8. Bisphosphonate-induced bilateral acute renal cortical necrosis

    Sema Aksoy, MD; Elif Hocaoglu, MD; Aylin Karahasanoglu, MD; Behlul Igus, MD; Mehtap Beker Acay, MD; Ercan Inci, MD

    2015-01-01

    Renal cortical necrosis (RCN), a rare cause of renal failure in which there is death of the renal cortex but sparing of the medulla, is a catastrophic entity with high mortality. Its incidence and severity are higher in developing countries, mostly due to pregnancy-related complications. This paper presents the case of a 65-year-old woman who had bilateral renal cortical necrosis caused by bisphosphonate medication that was diagnosed by CT scan during the acute initial phase of the disease.

  9. Synthetic cannabinoid hyperemesis resulting in rhabdomyolysis and acute renal failure.

    Argamany, Jacqueline R; Reveles, Kelly R; Duhon, Bryson

    2016-04-01

    Synthetic cannabinoid usage has increased in the past decade. Concurrently, emergency management of associated adverse effects due to synthetic cannabinoid usage has also risen. Reported toxicities include psychosis, seizures, cardiotoxicity, acute kidney injury, and death. While cannabis was first described as a cause of acute hyperemesis in 2004, a more recent case series also describes the association between cannabinoid hyperemesis and risk of acute renal failure. Synthetic cannabinoids have also been reported to cause acute hyperemesis and acute renal failure; however, the risk of rhabdomyolysis-induced renal failure has yet to be elucidated. In this article, we report the first known case of synthetic cannabinoid hyperemesis leading to rhabdomyolysis and acute renal failure. PMID:26422191

  10. Value of renal cortical scintigraphy in children with acute pyelonephritis

    Purpose: Acute pyelonephritis is a major cause of morbidity in children with urinary tract infection and can result in irreversible renal scarring leading to hypertension and end-stage renal disease. Tc-99m-dimercaptosuccinic acid (DMSA) scintigraphy is the imaging modality of choice for the detection of acute pyelonephhfis and renal scarfing. This study evaluated the importance of renal cortical scintigraphy to identify children at risk from renal damage due to acute pyelonephritis. Methods: Forty-nine children (ages 9 months to 11 years) with urinary tract infection having positive urine culture were studied. A DMSA scan was performed within 72 hours of receiving antibiotic during acute infection. Single or multiple areas of varying degrees of diminished cortical uptake or diffusely decreased uptake in an enlarged kidney was considered for the diagnosis of acute pyelonephrifis. Follow-up scintigraphy was done at 6 months of initial scan in children with acute pyelonephritis documented by DMSA scan. Renal scarring was considered if the affected kidney shows cortical thinning or focal cortical defect with loss of volume or become small kidney. Children with known renal tract abnormalities were excluded from the study. RESULTS: Twenty-seven children (55%) wine considered acute pyelonephritis by DMSA scintigraphy and the abnormality was bilateral in 17(63%) cases and unilateral in 10(37%) cases. Among these 44 abnormal kidneys, scintigraphy showed solitary defect in 29 kidneys, multiple defects in 6 kidneys and diffuse decreased uptake in 9 kidneys. Of them, twenty children were available for follow-up evaluation and scintigraphy demonstrated complete recovery in 21 of 34 (62%) kidneys and renal scarfing in 13 of 34 (38%) kidneys. Renal scarring was found in 5 of 7 kidneys (71%) with diffuse decreased uptake, 2 of 5 kidneys (40%) with multiple cortical defect and 6 of 22 (27%) with single focal detect. Conclusion: The scintigraphic pattern of acute pyelonephritis

  11. Hepatocyte growth factor prevents acute renal failure and accelerates renal regeneration in mice.

    Kawaida, K; Matsumoto, K.; Shimazu, H.; Nakamura, T.(International Center for Elementary Particle Physics and Department of Physics, The University of Tokyo, Tokyo, Japan)

    1994-01-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppre...

  12. Acute renal failure in pregnancy: our experience.

    Aggarwal, Rohina S; Mishra, Vineet V; Jasani, Anil F; Gumber, Manoj

    2014-03-01

    Acute renal failure (ARF) is a serious medical complication during pregnancy, and, in the post-partum period, is associated with significant maternal morbidity and mortality as well as fetal loss. The objective of our study is to find the etiology and maternal outcome of ARF during pregnancy. The study was conducted at the Obstetrics and Gynecology Department of the Institute of Kidney Disease and Research Center, Ahmedabad, India from January 2009 to January 2011. Fifty previously healthy patients who developed ARF, diagnosed on oliguria and serum creatinine >2 mg%, were included in the study. Patients with a known history of renal disease, diabetes and hypertension were excluded from the study. All patients were followed-up for a period of six months. Patient re-cords, demographic data, urine output on admission and preceding history of antepartum hemorrhage (APH), post-partum hemorrhage (PPH), septicemia, operative interventions and retained product of conception were noted and need for dialysis was considered. Patients were thoroughly examined and baseline biochemical investigations and renal and obstetrical ultrasound were performed on each patient and bacterial culture sensitivity on blood, urine or vaginal swabs were performed in selected patients. The age range was 19-38 years (mean 26 ± 3.8). The first trimester, second trimester and puerperal groups comprised of four (8%), 25 (50%) and 21 patients (42%), respectively. Hemorrhage was the etiology for ARF in 15 (30%), APH in ten (20%) and PPH in five (10%) patients. Eleven (22%) patients had lower segment cesarian section (LSCS) while 36 (78%) patients had normal vaginal delivery. In 20 (40%) patients, puerperal sepsis was the etiological factor, while pre-eclampsia, eclampsia and HELLP syndrome accounted for 18 (36%) patients. Two (4%) patients had disseminated intravascular coagulation on presentation while one (2%) patient was diagnosed with hemolytic uremic syndrome. Maternal mortality was 12% (n = 6

  13. Acute renal failure in pregnancy: Our experience

    Rohina S Aggarwal

    2014-01-01

    Full Text Available Acute renal failure (ARF is a serious medical complication during pregnancy, and, in the post-partum period, is associated with significant maternal morbidity and mortality as well as fetal loss. The objective of our study is to find the etiology and maternal outcome of ARF during preg-nancy. The study was conducted at the Obstetrics and Gynecology Department of the Institute of Kidney Disease and Research Center, Ahmedabad, India from January 2009 to January 2011. Fifty previously healthy patients who developed ARF, diagnosed on oliguria and serum creatinine >2 mg%, were included in the study. Patients with a known history of renal disease, diabetes and hypertension were excluded from the study. All patients were followed-up for a period of six months. Patient re-cords, demographic data, urine output on admission and preceding history of antepartum hemorrhage (APH, post-partum hemorrhage (PPH, septicemia, operative interventions and retained product of conception were noted and need for dialysis was considered. Patients were thoroughly examined and baseline biochemical investigations and renal and obstetrical ultrasound were performed on each patient and bacterial culture sensitivity on blood, urine or vaginal swabs were performed in selected patients. The age range was 19-38 years (mean 26 ± 3.8. The first trimester, second trimester and puerperal groups comprised of four (8%, 25 (50% and 21 patients (42%, respectively. Hemorrhage was the etiology for ARF in 15 (30%, APH in ten (20% and PPH in five (10% patients. Eleven (22% patients had lower segment cesarian section (LSCS while 36 (78% patients had normal vaginal delivery. In 20 (40% patients, puerperal sepsis was the etiological factor, while pre-eclampsia, eclampsia and HELLP syndrome accounted for 18 (36% patients. Two (4% patients had dissemi-nated intravascular coagulation on presentation while one (2% patient was diagnosed with hemolytic uremic syndrome. Maternal mortality was 12% (n

  14. Malaria induced acute renal failure: A single center experience

    Malaria has protean clinical manifestations and renal complications, particularly acute renal failure that could be life threatening. To evaluate the incidence, clinical profile, ou come and predictors of mortality in patients with malarial acute renal failure, we retrospectively studied the last two years records of malaria induced acute renal failure in patients with peripheral smear positive for malarial parasites. One hundred (10.4%) (63 males, 37 females) malaria induced acute renal failure amongst 958 cases of acute renal failure were evaluated. Plasmodium (P). falciparum was reported in 85%, P. vivax in 2%, and both in 13% patients. The mean serum creatinine was 9.2 ± 4.2 mg%, and oligo/anuria was present in 82%; 78% of the patients required hemodialysis. Sixty four percent of the patients recovered completely, 10% incompletely, and 5% developed chronic kidney failure; mortality occurred in 21% of the patients. Low hemoglobin, oligo/anuria on admission, hyperbilirubinemia, cerebral malaria, disseminated intravascular coagulation, and high serum creatinine were the main predictors of mortality. We conclude that malaria is associated with acute renal failure, which occurs most commonly in plasmodium falciparum infected patients. Early diagnosis and prompt dialysis with supportive management can reduce morality and enhance recovery of renal function (Author).

  15. Acute renal failure from rhabdomyolysis by heroin use: nursing approach

    Evangelia Prevyzi

    2013-04-01

    Full Text Available Rhabdomyolysis is caused by muscle breakdown resulting in the release of myoglobin into the systemic circulation. Acute renal failure results from the nephrotoxicity of myoglobin. Heroin use is one of the causes of rhabdomyolysis and acute renal failure. Aim: The aim of this literature review was highlight the importance of early recognition and treatment by a nurse of acute renal failure from rhabdomyolysis after heroin. Method: The method followed in this review was based on retrospective studies and research, conducted during the period 2000-2012 and retracted from the international databases Medline, Pubmed, Cinahl and the Greek database Iatrotek on acute renal failure from rhabdomyolysis after heroin use. Key-words were used: acute renal failure, rhabdomyolysis, heroin, international guidelines, based-evidence nursing care. Results: The clinical presentation occurs with muscle pain, muscle weakness, and brown-redish urine. High values of CPK and myoglobin make the diagnosis. Toxicology tests confirm heroin use. For the treatment is required naloxone administration, the rapid hydration of the patient, alkalinization of urine, good diuresis, regulation of electrolyte disturbances and dialysis if necessary. Conclusions: Early recognition and treatment of acute renal failure from rhabdomyolysis after heroin use is vital for the survival of the patient. It is necessary to educate nurses on specific issues such as acute renal failure from rhabdomyolysis after heroin use and the implementation of protocols for the treatment and cure.

  16. Outcomes of double-J catheter placement in treating refractory renal colic%双“J”管留置治疗顽固性肾绞痛的效果

    顾懿宁; 乐克平; 刘春林; 单勇

    2012-01-01

    目的 探讨留置双“J”管治疗上尿路疾病引起顽固性肾绞痛的价值.方法 顽固性肾绞痛患者118例(A组),采用输尿管镜下留置双“J”管急诊治疗成功;选择同期各种原因未置双“J”管而仅予对症处理的顽固性肾绞痛患者57例作为对照(B组).比较两组的疼痛转归及肾功能恢复情况.结果 A组患者疼痛程度明显减轻,治疗有效率高于B组(98.3%vs.66.7%)(P<0.05).同时,急性梗阻性肾功能不全患者置双“J”管后肾功能明显好转,尿量>400 ml/d.结论 顽固性肾绞痛患者急诊输尿管镜下留置双“J”管,能迅速缓解肾绞痛,改善肾功能.%Objective To investigate the outcomes of double-J catheter placement in treating refractory renal colic. Methods A total of 118 casesCgioup A) with refractory renal colic caused by the upper urinary tract disease was successfully placed double-J catheter through emergency ureteroscope and 57 cases( group B) with the same diagnosis as in group A were treated only with medicine because of various reasons without double-J catheter placement. The improvements in pain and renal (unction were compared. Results The effectiveness rate was higher in group A than that in group B198. 3% vs. 66.7%)(P<0. 05). Renal colic in group A was attenuated and renal function of obstructive nephropathy improved obviously though double-J catheter placement with urinary volume of greater than 400 ml/i Conclusien Placing double-J catheter through emergency ureteroscope can quickly and effectively attenuate refractory renal colic and improve renal function.

  17. Association with meteo-climatological factors and daily emergency visits for renal colic and urinary calculi in Cuneo, Italy. A retrospective observational study, 2007-2010

    Condemi, Vincenzo; Gestro, Massimo; Dozio, Elena; Tartaglino, Bruno; Corsi Romanelli, Massimiliano Marco; Solimene, Umberto; Meco, Roberto

    2015-03-01

    The incidence of nephrolithiasis is rising worldwide, especially in women and with increasing age. Incidence and prevalence of kidney stones are affected by genetic, nutritional, and environmental factors. The aim of this study is to investigate the link between various meteorological factors (independent variables) and the daily number of visits to the Emergency Department (ED of the S. Croce and Carle Hospital of Cuneo for renal colic (RC) and urinary stones (UC) as the dependent variable over the years 2007-2010. The Poisson generalized regression models (PGAMs) have been used in different progressive ways. The results of PGAMs (stage 1) adjusted for seasonal and calendar factors confirmed a significant correlation ( p 1), with a first peak after 5 days (lag ranges 0-1, 0-3, and 0-5) and a second weak peak observed along the 5-15 lag range days. The estimated RR for females was significant, mainly in the second and fourth age group considered (19-44 and >65 years): RR for total ED visits 1.27, confidence interval (CI) 1.11-1.46 (lag 0-5 days); RR 1.42, CI 1.01-2.01 (lag 0-10 days); and RR 1.35, CI 1.09-1.68 (lag 0-15 days). The research also indicated a moderate involvement of the thermal factor in the onset of RC caused by UC, exclusively in the female sex. Further studies will be necessary to confirm these results.

  18. Inconsequence of membrane choice in acute renal failure?

    Mujais, S K; Ivanavich, P

    1996-05-01

    The choice of hemodialysis membrane in acute renal failure has caused a heated debate, principally because of the dogmatism with which the results of preliminary clinical studies have been translated into prescription dictum. The issue, however, is not merely the limitations of these two studies, but rather the shift in emphasis they may have engendered in the approach to dialytic therapy in acute renal failure. Dogmatism based on limited or flawed data does not serve the interests of our patients, and the issue of hemodialysis in acute renal failure is far more complex than the exaggerated importance of membrane choice. PMID:8725627

  19. Renal Biopsy Findings in Acute Renal Failure in the Cohort of Patients in the Spanish Registry of Glomerulonephritis

    López-Gómez, Juan M.; Rivera, Francisco

    2008-01-01

    Background and objectives: Renal biopsy in acute renal failure of unknown origin provides irreplaceable information for diagnosis, treatment, and prognosis. This study analyzed the frequency and clinicopathologic correlations of renal native biopsied acute renal failure in Spain during the period 1994 through 2006.

  20. RENAL REPLACEMENT THERAPY IN ACUTE KIDNEY FAILURE - AN OVERVIEW

    Treesa P. Varghese

    2014-10-01

    Full Text Available Renal failure is the loss of renal function, either acute or chronic, that results in azotemia and syndrome of uremia. Acute renal failure, is also known as acute kidney injury (AKI, is defined as an abrupt (within 48 hours reduction in kidney function. The initial management of acute kidney failure involves treating the underlying cause, stopping nephrotoxic drugs and ensuring that the patient is euvolaemic with an adequate mean arterial blood pressure. However, no specific treatments have been shown to reverse the course AKF so Renal Replacement Therapy (RRT is the cornerstone of further management. RRT therapy can be administrated either intermittently or continuously. Multiple modalities of RRT are currently available. The purpose of this review is to familiarize different modalities of RRT for blood purification.

  1. Gallbladder metastasis from renal cell carcinoma mimicking acute cholecystitis

    Sand M

    2009-02-01

    Full Text Available Abstract Renal cell carcinoma constitutes about 3% of adult malignancies. It has a high metastatic potential associated with synchronous or metachronous metastatic disease. Further, it is known to metastasize mainly to the lung, bone, brain, liver, or adrenal glands. In very rare cases it can metastasize to the gallbladder mimicking acute cholecystitis on clinical exam. In this case we present a patient who developed a gallbladder metastasis five years after a renal cell carcinoma mimicking acute cholecystitis.

  2. Acute Renal Failure in Liver Transplant Patients: Indian Study

    Naik, Pradeep; Premsagar, B.; Mallikarjuna, M.

    2013-01-01

    The acute renal failure is the frequent medical complication observed in liver transplant patients. The objective of this study was to determine the cause of acute renal failure in post liver transplant patients. A total of 70 patients who underwent (cadaveric 52, live 18) liver transplantation were categorized based on clinical presentation into two groups, namely hepatorenal failure (HRF, n = 29), and Hepatic failure (HF, n = 41). All the patients after the liver transplant had received tac...

  3. Hepatocyte Growth Factor Prevents Acute Renal Failure of Accelerates Renal Regeneration in mice

    Kawaida, Kouichi; Matsumoto, Kunio; Shimazu, Hisaaki; Nakamura, Toshikazu

    1994-05-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppressed increases in blood urea nitrogen and serum creatinine caused by administration of cisplatin, a widely used antitumor drug, or HgCl_2, thereby indicating that HGF strongly prevented the onset of acute renal dysfunction. Moreover, exogenous HGF stimulated DNA synthesis of renal tubular cells after renal injuries caused by HgCl_2 administration and unilateral nephrectomy and induced reconstruction of the normal renal tissue structure in vivo. Taken together with our previous finding that expression of HGF was rapidly induced after renal injuries, these results allow us to conclude that HGF may be the long-sought renotropic factor for renal regeneration and may prove to be effective treatment for patients with renal dysfunction, especially that caused by cisplatin.

  4. Post-renal acute renal failure due to a huge bladder stone

    Orcun Celik

    2014-06-01

    Full Text Available A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography scan showed a huge bladder stone (5 cm x 6 cm x 5 cm with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure.

  5. Clinical Analysis of Ureteroscopy for the Treatment of 22 Patients with Refractory Renal Colic During Pregnancy%输尿管镜治疗妊娠合并顽固性肾绞痛22例临床分析

    胡杰彬; 李进; 李文泽

    2014-01-01

    [目的]探讨利用输尿管镜微创技术治疗妊娠期合并顽固性肾绞痛的可行性及临床效果。[方法]回顾性分析22例输尿管镜治疗妊娠合并顽固性肾绞痛患者的临床资料。[结果]所有患者肾绞痛,发热等症状消失。20例一次性碎石成功(90.9%),2例输尿管上段结石因结石上方输尿管扩张明显,碎石上移到肾盂,予以留置双J管,产后予以体外冲击波碎石治愈。本组无大出血,输尿管穿孔,撕脱等严重并发症,22例患者均顺利度过围产期,并分娩健康婴儿。[结论]妊娠合并顽固性肾绞痛患者采用输尿管镜治疗是安全有效的。%[Objective] To explore the feasibility and clinical efficacy of ureteroscopy for the treatment of refractory renal colic during pregnancy .[Methods] Clinical data and treatment of 22 patients with refractory renal colic during pregnancy were retrospectively analyzed .[Results]Symptoms such as fever of all patients with renal colic disappeared .One-time successful lithotripsy was obtained in 20 cases(90 .9% ) .The stones of 3 patients with upper ureteral calculi moved to renal pelvis due to obvious dilatation of ureter above the calculi , and these 2 cases were placed with double J-tube and cured by extracorporeal shock wave lithotripsy after the delivery .No severe complications such as massive hemorrhage ,ureteral perforation and avulsion occurred in the group .All 22 patients were delivered with healthy babies after safe perinatal period .[Conclusion] Uret-eroscopy for the treatment of patients with refractory renal colic during pregnancy is safe and effective .

  6. 急性肾绞痛患者B超联合腹部X线平片与平扫CT诊断尿路结石的比较研究%Comparison between ultrasonography with plain abdominal radiography and unenhanced computed tomography in the diagnosis of urinary calculi with renal colic

    曾筱江; 刘丽华; 涂响安

    2013-01-01

    Objective:To compare the effect between ultrasonography and plain abdominal radiography with unenhanced computed tomography ( CT) for the diagnosis of urinary calculi in patients with renal colic . Methods; Sixty-iiine patients with renal colic were diagnosed with ultrasonography ; plain abdominal radiography and unenhanced computed tomography. The findings of two methods were compared. Results: 59 of 69 patients were confirmed to have urinary calculi by follow -up. Ultrasonography with plain abdominal radiography detected 44 of the 59 patients with calculi (sensitivity 74. 6% and specificity 100% ). Unenhanced CT detected 55 of 59 patients, (sensitivity 93. 2% and specificity 100% ). Sensitivity of the two methods is of statistical differences in the diagnosis of acute renal colic urolithiasis patients. Conclusion: Unenhanced CT is more sensitive for detecting urolithiasis than ultrasonography with plain abdominal radiography.%目的:比较B超联合腹部X线平片(KUB)和平扫CT在诊断急性肾绞痛患者尿路结石的效能.方法:对69例因急性肾绞痛在我院泌尿外科门诊或者急诊的患者进行B超联合KUB和平扫CT检查,并对两种诊断方法的诊断效能进行对比研究.结果:经过3个月的随访,69例中确诊患有尿路结石59例.B超联合KUB诊断急性肾绞痛患者尿路结石的敏感度为74.6%(44/59),特异度为100%(10/10).CT平扫诊断急性肾绞痛患者尿路结石的敏感度为93.2%(55/59),特异度为100%(10/10).两种影像学方法诊断急性肾绞痛患者尿路结石的敏感度比较差异有统计学意义(P<0.05).结论:平扫CT用于诊断急性肾绞痛患者尿路结石的敏感度优于B超联合KUB.

  7. Renal and post-renal causes of acute renal failure in children

    Objective: To identify the causes of acute renal failure (ARF) in pediatric population along with the identification of the age and gender most affected by the failure. Subjects and Methods: The study included children under the age of 12 years who presented with signs and symptoms suggestive of ARF (oliguria/anuria, vomiting, acidotic breathing etc.) along with raised blood urea nitrogen (BUN) serum creatinine and metabolic acidosis as shown by arterial blood gases (ABGs). Patients were divided into two group on the basis of age; group A consisting of 0-2 years and group B from >2 years. Patients presenting with transient pre-renal azotaemia were excluded from the study. After providing initial emergency cover, detailed history, physical examination and investigations were carried out according to a proforma specially designed to ascertain the cause of ARF. Patients were managed for ARF as per standard recommendations and investigations completed or repeated as and when required. Results: A total of 119 patients with ARF were admitted in the ward over a period of two years constituting 1.36% of the total admissions and 16.39% of the admissions due to renal pathology. Mean age of presentation was 4.5 years 16.7% of the patients under the age of 5 years. Male predominance was noted in all ages with an overall male to female ratio of 2.3:1. Most common cause leading to ARF in younger age group was found to be hemolytic uremic syndrome [25(54.34%)] followed by septicemia [7(15.21 %)]. In older patients renal calculus disease was the most common [22(30.13%)] underlying pathology followed by pre-existing, undiagnosed chronic renal failure [16(21.91 %)]. Conclusion: ARF is fairly cotton in children especially under the age of 5 years showing a male predominance. More than 90% of the cases can be prevented by improving primary health care and by early and prompt treatment of infections. (author)

  8. Using continuous renal replacement therapy to manage patients of shock and acute renal failure

    Soni Sachin; Nagarik Amit; Adikey Gopal; Raman Anuradha

    2009-01-01

    Background: The incidence of acute renal failure (ARF) in the hospital setting is increasing. It portends excessive morbidity and mortality and a considerable burden on hospital resources. Extracorporeal therapies show promise in the management of patients with shock and ARF. It is said that the potential of such therapy goes beyond just providing renal support. The aim of our study was to analyze the clinical setting and outcomes of critically ill ARF patients managed with continuous renal r...

  9. [Acute renal failure caused by phenazopyridine].

    Vega, Jorge

    2003-05-01

    A 27 years old woman was admitted due to abdominal cramps, jaundice and oligoanuria, starting 48 hours after eating Chinese food. Hepatic biochemical tests, abdominal ultrasound and retrograde pyelography were normal. The urine was intensely orange colored and microscopic analysis was normal. The serum creatinine and urea nitrogen on admission were 4.59 and 42.5 mg/dl and rose to 13.5 and 72.4 mg/dl, respectively, at the 6th hospital day. Oliguria lasted only 48 hours. Dialysis was not used, since the patient was in good general condition and uremic symptoms were absent. On the 7th day, azotemia began to subside and at the 14th day, serum creatinine was 1.0 mg/dl. Before hospital discharge, she confessed the ingestion of 2.000 mg of phenazopyridine, during a nervous breakdown, aiming to sleep deeply. Remarkable was the persistence of the orange color of her urine during several days and the dissociation between the rate of increase of serum creatinine with respect to urea nitrogen. This is an unusual case of acute renal failure caused by an overdose of a drug, commonly prescribed for urinary tract infections. PMID:12879816

  10. Ceftriaxone-related hemolysis and acute renal failure.

    Demirkaya, Erkan; Atay, Abdullah Avni; Musabak, Ugur; Sengul, Ali; Gok, Faysal

    2006-05-01

    A 5-year-old girl with no underlying immune deficiency or hematologic disease was treated with a combination of ceftriaxone and ampicilline-sulbactam for pneumonia. On the ninth day of the therapy, she developed oliguria, paleness, malaise, immune hemolytic anemia (IHA) and acute renal failure (ARF). Laboratory studies showed the presence of antibodies against ceftriaxone. Acute interstitial nephritis (AIN) was diagnosed by renal biopsy. The patient's renal insufficiency was successfully treated with peritoneal dialysis without any complications. The patient recovered without any treatment using steroids or other immunosuppressive agents. PMID:16491410

  11. 杜冷丁与盐酸曲马多治疗肾绞痛的疗效对比观察%Dolantin tramadol hydrochloride and the treatment of renal colic compared to observe the effect

    麦海棠

    2009-01-01

    目的 观察杜冷丁和盐酸曲马多对肾绞痛的镇痛效果.方法 将84例肾绞痛患者随机分为杜冷丁组42例,盐酸曲马多组42例,分别给予杜冷丁和盐酸曲马多镇痛.采用VRSs-4和NRS分析两种药物后的镇痛效果,同时观察药物不良反应.结果 杜冷丁组镇痛效果和起效时间优于盐酸曲马多组(Prenal colic pain of the clinical results.Methods 84 cases of renal colic were randomly divided into groups of 42 cases of dolantin,tramadol hydrochloride group of 42 cases,respectively,to give dolantin and analgesic tramadol hydrochloride.Use VRSs-4 and NRS analysis of the two drugs after the analgesic effect of adverse drug reactions observed at the same time.Results Group dolantin analgesic effect and the onset time is better than tramadol hydrochloride group (Prenal colic have a therapeutic effect,the group is better than dolantin tramadol hydrochloride group,but should pay attention to their adverse reactions.

  12. 急诊腔内碎石治疗输尿管中、下段结石肾绞痛%Transureteroscopic Pneumatic Lithotripsy in the Emergent Treatment of Middee and Low Ureteral Stones with Renal Colic

    王新江; 匡全美; 王孝武

    2011-01-01

    Objective To evaluate transureteroscopic pneumatic lithotripsy in the emergent treatment of middle and low ureteral stones with renal colic. Methods A retrospective analysis was done on 32 cases of middle and low ureteral stones with renal colic, who received the emergent treatment of transureteroscopic pneumatic lithotripsy. Results 30 cases were fragmented successfully, the failure of inserting the ureteroscope in 2 cases were placed the double-J ureteral stent, the symptoms were eased or disappeared; 1 case was found the perforation of ureter, Urinary tract infection occurred in 1 case. Conclusion Emergent treatment of middle and low ureteral stones with renal colic by this method is safe, effective and less invasive, and could be the optimal treatment for the disease.%目的 探讨急诊气压弹道碎石治疗输尿管中、下段结石肾绞痛的效果.方法 对32例输尿管中、下段结石肾绞痛患者采用急诊气压弹道碎石治疗效果进行回顾性分析.结果 30例碎石成功,2例进镜失败,置双J管症状缓解或消失.术中发生输尿管穿孔1例,术后感染1例.结论 急诊气压弹道碎石术治疗输尿管中、下段结石成功率高、安全可靠,可作为输尿管中、下段结石肾绞痛的首选治疗方法.

  13. Clinical curative effect of dezocine combined with phloroglucin in the treatment of renal colic%地佐辛联合间苯三酚治疗肾绞痛的临床效果

    王书升

    2015-01-01

    Objective:To explore the analgesic effect of dezocine combined with phloroglucin in the treatment of renal colic. Methods:120 cases of patients with renal colic were selected,they were randomly divided into the treatment group and the control group with 60 cases in each group,the treatment group was treated with dezocine injection combined with phloroglucin,the control group was treated with meperidine hydrochloride injection combined with anisodamine,we compared the analgesic effect and adverse reactions of the two groups.Results:In the treatment group,the symptoms were significantly improved,the analgesic effect and adverse reaction rate were superior to the control group(P<0.05).Conclusion:The clinical curative effect of dezocine combined with phloroglucin in the treatment of renal colic was good,adverse reactions were few.%目的:探讨地佐辛注射液联合间苯三酚治疗肾绞痛患者的效果。方法:收治肾绞痛患者120例,随机分成治疗组和对照组各60例,治疗组给予地佐辛注射液联合间苯三酚治疗,对照组给予哌替啶注射液联合山莨菪碱治疗,比较两组的镇痛效果及不良反应。结果:治疗组的症状显著改善,镇痛效果及不良反应发生率优于对照组(P<0.05)。结论:地佐辛联合间苯三酚治疗肾绞痛镇痛效果好,不良反应少。

  14. INTERMEDIATE SYNDROME: A TYPICAL PATTERN OF PRE-RENAL ACUTE RENAL FAILURE IN THE ELDERLY

    Greloni G; Algranati L; Pidoux R; Reynaldi J; Musso CG; Luque K,

    2004-01-01

    Acute renal failure is a frequent entity in the elderly. This is due on one hand to the structural and physiological changes of the aged kidney, and on the other hand to the exposure of this population to polypharmacy and their reduced capability to metabolize drugs. In the present report we present a case of a seventy year-old woman who developed acute renal failure secondary to severe dehydration with a clinical and laboratory pattern of intermediate syndrome: laboratory results compatib...

  15. Bisphosphonate-induced bilateral acute renal cortical necrosis

    Sema Aksoy, MD

    2015-01-01

    Full Text Available Renal cortical necrosis (RCN, a rare cause of renal failure in which there is death of the renal cortex but sparing of the medulla, is a catastrophic entity with high mortality. Its incidence and severity are higher in developing countries, mostly due to pregnancy-related complications. This paper presents the case of a 65-year-old woman who had bilateral renal cortical necrosis caused by bisphosphonate medication that was diagnosed by CT scan during the acute initial phase of the disease.

  16. Association with meteo-climatological factors and daily emergency visits for renal colic and urinary calculi in Cuneo, Italy. A retrospective observational study, 2007-2010.

    Condemi, Vincenzo; Gestro, Massimo; Dozio, Elena; Tartaglino, Bruno; Corsi Romanelli, Massimiliano Marco; Solimene, Umberto; Meco, Roberto

    2015-03-01

    The incidence of nephrolithiasis is rising worldwide, especially in women and with increasing age. Incidence and prevalence of kidney stones are affected by genetic, nutritional, and environmental factors. The aim of this study is to investigate the link between various meteorological factors (independent variables) and the daily number of visits to the Emergency Department (ED of the S. Croce and Carle Hospital of Cuneo for renal colic (RC) and urinary stones (UC) as the dependent variable over the years 2007-2010.The Poisson generalized regression models (PGAMs) have been used in different progressive ways. The results of PGAMs (stage 1) adjusted for seasonal and calendar factors confirmed a significant correlation (p nonlinear models (DLNMs)-stage 2], expressed in terms of relative risk (RR) and cumulative relative risk (RRC), indicated a relative significant effect up to 15 lag days of lag (RR > 1), with a first peak after 5 days (lag ranges 0-1, 0-3, and 0-5) and a second weak peak observed along the 5-15 lag range days. The estimated RR for females was significant, mainly in the second and fourth age group considered (19-44 and >65 years): RR for total ED visits 1.27, confidence interval (CI) 1.11-1.46 (lag 0-5 days); RR 1.42, CI 1.01-2.01 (lag 0-10 days); and RR 1.35, CI 1.09-1.68 (lag 0-15 days). The research also indicated a moderate involvement of the thermal factor in the onset of RC caused by UC, exclusively in the female sex. Further studies will be necessary to confirm these results. PMID:24970114

  17. Lipopolysaccharide-induced acute renal failure in conscious rats

    Jonassen, Thomas E N; Graebe, Martin; Promeneur, Dominique;

    2002-01-01

    In conscious, chronically instrumented rats we examined 1) renal tubular functional changes involved in lipopolysaccharide (LPS)-induced acute renal failure; 2) the effects of LPS on the expression of selected renal tubular water and sodium transporters; and 3) effects of milrinone, a......-alpha and lactate, inhibited the LPS-induced tachycardia, and exacerbated the acute LPS-induced fall in GFR. Furthermore, Ro-20-1724-treated rats were unable to maintain MAP. We conclude 1) PDE3 or PDE4 inhibition exacerbates LPS-induced renal failure in conscious rats; and 2) LPS treated rats develop an...... phosphodiesterase type 3 (PDE3) inhibitor, and Ro-20-1724, a PDE4 inhibitor, on LPS-induced changes in renal function. Intravenous infusion of LPS (4 mg/kg b.wt. over 1 h) caused an immediate decrease in glomerular filtration rate (GFR) and proximal tubular outflow without changes in mean arterial pressure (MAP...

  18. 妊娠期输尿管结石并发顽固性肾绞痛的微创治疗%Minimally invasive treatment of ureteral calculi with period of refractory renal colic during pregnancy

    卢文武; 张建育; 刘榕臻; 李毅宁; 王明镑; 洪传芳

    2014-01-01

    Objective To evaluate the safety and efifcacy of treatment of refractory renal colic due to ureteric calculi during pregnancy. Methods In our hospital in September 2009 to June 2014, clinical data of 18 pregnant women with refractory renal colic due to ureteric calculi in my hospital were collected and retrospectively analyzed.13 cases received intra-ureteral double-J cannula alone. 5 cases received intra-ureteral double-J cannula after ureteroscopic pneumatic lithotripsy. Results Renal colic was relieved in 18 cases after operation. All the pregnant women had normal delivery and gave birth to healthy babies. Conclusion For pregnant women with refractory renal colic due to ureteric calculi, intra-ureteral cannula alone and intra-ureteral double-J cannula after ureteroscopic pneumatic lithotripsy treatment are safe and effective.%目的:探讨妊娠期输尿管结石并发顽固性肾绞痛的微创治疗的安全性及疗效。方法对我院2009年9月~2014年6月,共18例妊娠期输尿管结石并发顽固性肾绞痛的患者,进行回顾性分析。13例患者采用输尿管置管术,5例患者采用输尿管镜气压弹道碎石+输尿管置管术治疗。结果18例患者肾绞痛都得到有效缓解,均顺利生产,婴儿健康。结论对妊娠期输尿管结石并发顽固性肾绞痛患者采用输尿管置管术、输尿管镜气压弹道碎石+输尿管置管术等微创外科治疗技术,是安全有效的。

  19. Outpatient emergency treatment by ESWL for ureteral calculi with renal colic%门诊急诊ESWL治疗输尿管结石伴肾绞痛疗效分析

    吕金东; 汤元杰; 张丽; 李书铃; 陶淑芬

    2013-01-01

    目的 探讨门诊急诊ESWL治疗输尿管结石伴肾绞痛的治疗效果.方法 回顾性分析2010年1月~2012年4月门诊急诊ESWL治疗输尿管结石伴肾绞痛的体外冲击波治疗的效果.结果 经1次碎石后肾绞痛缓解者715例(89.4%),经1次治疗后结石排净者660例(82.5%),经2~5次治疗后结石排净者126例(15.8%),结石总排净率为98.3%.失败14例,失败者均转入外科行肾镜输尿管镜或手术治疗.结论 门诊急诊ESWL治疗输尿管结石伴肾绞痛效果满意,是治疗输尿管结石伴肾绞痛的首选治疗手段.%OBJECTIVE To investigate outpatient emergency treatment by extracorporeal shock wave lithotripsy (ESWL) for ureteral calculi with renal colic. METHODS A retrospective analysis was made on the effect of outpatient emergency treatment by ESWL for ureteral calculi with renal colic from January, 2010 to April, 2012. RESULTS After one time of ESWL, the o-dynolysis rate and lithecbole rate were 89.4% and 82.5% respectively. The lithecbole rate after 2-5 times of ESWL was 15.8%, and the total lithecbole rate was 98.3%. 14 cases were failed, and were transferred to urinary surgery to do examins by nephro-scope or ureteroscope surgical treatment or surgical operation. CONCLUSION Outpatient emergency treatment by ESWL for ureteral calculi with renal colic is very effective, and can be the first choice for the treatment of ureteral calculi with renal colic.

  20. Efficacy of Nifedipine in the treatment of renal colic:Observation on 42 cases%硝苯地平治疗肾输尿管绞痛42例疗效观察

    常莉; 董芸; 陈锋

    2012-01-01

    Objective To observe the clinical and side effect of Nifedipine in the treatment of renal colic. Methods Forty-two cases of renal or ureteral colic were randomized into two groups;one was treated with Nifedipine and the other with Atropine and Pethidine. The two groups were compared in the efficacy and side effects for renal or ureteral colic. Results The effective rate and total effective rate of the two groups were not significantly different (P > 0.05).The incidences of side effects such as lethargy, headache, dry mouth, palpitation in the Nifedipine group were lower than those in the other group (P < 0. 05) . Conclusion Nifedipine is effective,fast and safe in relieving renal and ureteral colic,and has fewer side effects.%目的 观察硝苯地平治疗肾绞痛的疗效和不良反应.方法 肾或输尿管绞痛患者42例分为硝苯地平组(n=22)和阿托品加盐酸哌替啶组(n=20),观察比较硝苯地平和阿托品加盐酸哌替啶缓解肾、输尿管绞痛的效果及不良反应.结果 两组显效率和总有效率比较差异均无统计学意义(P>0.05);硝苯地平组出现嗜睡、头痛、口干、心悸等不良反应均低于阿托品联用盐酸哌替啶组(P<0.05).结论 硝苯地平有较强的缓解肾、输尿管绞痛的作用,且见效快、安全性较高、不良反应少.

  1. The Treatment of 28 Renal Colic Patients by Transfusing a Saline Drip in AShi Points%肾周阿是穴注射生理盐水治疗肾绞痛28例

    何国华; 赵志亮

    2015-01-01

    Objective: To observe the clinical effect of saline drips in AShi points peripheral kidney on the treatment of renal colic. Methods:The 56 cases of renal colic randomized into treatment and control groups with 28 cases in each. Both groups administered such conventional medicines for renal colic as nonsteroidal anti-inflamma-tory drugs, opioid analgesics as well as spasmolytics, the observation group were injected saline drips in AShi points around kidney. Results:The time for pain relieving and disappearing in the observation group was shorter than those in the control group, the differences in comparison of the time between two groups were significant (P<0.05);the differences in the comparison between the total effective rates of 96.43%in the observation group and 85.71%in the control group were obvious (P<0.05). Conclusion:The saline drips in AShi pionts are significantly effective in cur-ing renal colic and faster in stopping its pain.%目的:观察肾周阿是穴穴位注射生理盐水治疗肾绞痛的临床疗效。方法:将56例肾绞痛患者随机分为治疗组、对照组各28例。2组均给予非甾体类镇痛抗炎药、阿片类镇痛药及解痉药等肾绞痛常规治疗;观察组同时采用生理盐水肾周阿是穴穴位注射治疗。结果:疼痛缓解时间、疼痛消失时间观察组均短于对照组,2组比较差异有统计学意义(P<0.05)。总有效率观察组为96.43%,对照组为85.71%,2组比较差异有统计学意义(P<0.05)。结论:肾周阿是穴穴位注射生理盐水治疗肾绞痛临床疗效显著,可较快缓解肾绞痛。

  2. Acute transplant renal artery thrombosis due to distal renal artery stenosis: A case report and review of the literature

    Fallahzadeh, Mohammad Kazem; Yatavelli, Rajini Kanth; Kumar, Ajay; Singh, Neeraj

    2014-01-01

    Background: Acute renal artery thrombosis is a devastating complication of renal transplantation that can result in graft loss if not detected early. Surgical and technical errors are the major cause of renal artery thrombosis. In this article, for the first time, we are reporting a case of acute renal artery thrombosis that developed early post-transplantation due to distal renal artery stenosis. Case Presentation: A 71-year-old woman presented with nausea, vomiting and decreased urine outpu...

  3. Asymptomatic acute pyelonephritis as a cause of acute renal failure in the elderly.

    Woodrow, G; Patel, S.; Berman, P; Morgan, A G; Burden, R. P.

    1993-01-01

    Urinary tract infections in the elderly are common, often asymptomatic and usually benign. We report three patients who presented with acute renal failure due to acute pyelonephritis in the absence of clinical findings of infection or urinary tract obstruction. Blood and urine cultures grew Escherichia coli in two of the patients and in two patients renal biopsy confirmed acute pyogenic pyelonephritis. Antimicrobial therapy and haemodialysis led to improvement, though one patient subsequently...

  4. Acute renal failure and severe thrombocytopenia associated with metamizole

    Maria Dolores Redondo-Pachon

    2014-01-01

    Full Text Available Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diag-nosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis. We report a case of acute renal failure and severe thrombocytopenia after metamizole. As far as we know, this combination of adverse effects from this drug has not been reported previously.

  5. Acute renal failure and severe thrombocytopenia associated with metamizole.

    Redondo-Pachon, Maria Dolores; Enriquez, Ricardo; Sirvent, Ana Esther; Millan, Isabel; Romero, Alberto; Amorós, Francisco

    2014-01-01

    Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diagnosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis. We report a case of acute renal failure and severe thrombocytopenia after metamizole. As far as we know, this combination of adverse effects from this drug has not been reported previously. PMID:24434395

  6. Nebulized Pentamidine-Induced Acute Renal Allograft Dysfunction

    Siddhesh Prabhavalkar

    2013-01-01

    Full Text Available Acute kidney injury (AKI is a recognised complication of intravenous pentamidine therapy. A direct nephrotoxic effect leading to acute tubular necrosis has been postulated. We report a case of severe renal allograft dysfunction due to nebulised pentamidine. The patient presented with repeated episodes of AKI without obvious cause and acute tubular necrosis only on renal histology. Nebulised pentamidine was used monthly as prophylaxis for Pneumocystis jirovecii pneumonia, and administration preceded the creatinine rise on each occasion. Graft function stabilised following discontinuation of the drug. This is the first report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allograft. This diagnosis should be considered in a case of unexplained acute renal allograft dysfunction.

  7. Imaging in acute renal infection in children

    Sty, J.R.; Wells, R.G.; Starshak, R.J.; Schroeder, B.A.

    1987-03-01

    Infection is the most common disease of the urinary tract in children, and various imaging techniques have been used to verify its presence and location. On retrospective analysis, 50 consecutive children with documented upper urinary tract infection had abnormal findings on renal cortical scintigraphy with 99mTc-glucoheptonate. The infection involved the renal poles only in 38 and the poles plus other renal cortical areas in eight. Four had abnormalities that spared the poles. Renal sonograms were abnormal in 32 of 50 children. Excretory urograms were abnormal in six of 23 children in whom they were obtained. Vesicoureteral reflux was found in 34 of 40 children in whom voiding cystourethrography was performed. These data show the high sensitivity of renal cortical scintigraphy with 99mTc-glucoheptonate in documenting upper urinary tract infection. The location of the abnormalities detected suggests that renal infections spread via an ascending mode and implies that intrarenal reflux is a major contributing factor.

  8. Acute renal infarction resulting from fibromuscular dysplasia: a case report

    Saarinen, Harri Juhani; Palomäki, Ari

    2016-01-01

    Background Acute abdominal pain is one of the most frequent complaints evaluated at emergency departments. Approximately 25 % of abdominal pain patients discharged from emergency departments are diagnosed with undifferentiated abdominal pain. One possible reason for acute abdominal pain is renal infarction. Diagnosis is difficult and often late. Case presentation A white, 33-year-old, previously healthy Finnish man came to our emergency department because of acute abdominal pain. After evalua...

  9. Clostridium difficile causing acute renal failure: Case presentation and review

    Jasmin Arrich; Gottfried H. Sodeck; Gürkan Seng(o)lge; Christoforos Konnaris; Marcus Müllner; Anton N. Laggner; Hans Domanovits

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

  10. Can acute renal scintigraphy abnormalities predict the evolution of renal damage in children with pyelonephritis?

    Acute pyelonephritis (APN) in childhood can lead to renal scarring (RS), which carries a risk of subsequent hypertension and renal failure. Every effort must be done in order to identify high risk children who need a more close follow-up. Renal scintigraphy is the procedure of choice for diagnosis and follow-up of children with APN. The aim of this prospective study was to correlate the acute renal scintigraphic abnormalities with the developing of RS in children with APN. We prospectively analyzed 47 patients (94 renal units (RU)), 24 girls, with a first episode of APN diagnosed with renal scintigraphy performed during the first months of the beginning of the symptoms. All children with urinary tract malformations were excluded. The mean age of the group was 1.35 yrs. Follow up scan was performed at least six months after the acute episode. Abnormal findings are presented. During follow up, scar was considered when there was an improvement or no changed of acute abnormalities. Among the 94 RU, 54 had APN. In the follow-up scan there was a normalization of renal parenchymal abnormalities in 33/54 (61 %) and in 21/54 (39%) there was an improvement or no changes (scar). The relation between acute scintigraphic abnormalities and renal scars are presented. The evolution of scintigraphic abnormalities in children with APN is also presented. According to our results, RS developed significant more in kidneys with decreased size (p=0.05), diffuse parenchymal abnormalities (p=0.02) and relative renal function less than 45% (p=0.008), specially if it was less or equal to 35% (p=0.00008). Therefore, we can predict a worst evolution in kidneys with these anomalies during APN