Renal colic - cramping pain attack which occurs suddenly, without any - any predisposing symptoms and is directly related to violation of the outflow of urine from the kidneys.In most cases, the attack caused by the presence of stones in the ureter, or renal pelvis of the kidney. Often, the pain may be accompanied by urinary disorders (frequent and painful), nausea and vomiting.In some cases, the pain may trail off as suddenly as it had come, but often subsides gradually becomes dull, and then escalates.It is accompanied by bloating and gas diverting complicated.
Statistically urgent medical care, renal colic is the second in frequency after acute appendicitis (not counting various injuries)
Etiology and Pathogenesis
The causes can be:
- Various inflammatory processes calyx - pelvis system
- who abuse the passage of urine sharply arising mechanical obstacles
- Reactive allergic phenomena in the mucosa of the upper urinary tract
- hemodynamic abnormalities in the kidne
- spasticity arising reflex in the upper urinary tract in myocardial infarction, appendicitis, cholecystitis, etc.
cause of renal colic may be: pyelonephritis, urolithiasis, nephroptosis, violation of mineral metabolism, hydronephrosis , tumor pelvis and kidney abnormalitiesdevelopment, prostate disease , post radial ureteral stricture, genitourinary tuberculosis, periureterit.In about 38% of recorded cases - the exact cause of renal colic can not be established
- sharp pain in the region of an edge - vertebral angle, which sometimes descends, moving in the groin
- Due to the movement of stone painmuch more important than when it is stationary
- intestinal or biliary colic - pain changeable, and in renal - permanent with short moments of relief and mandatory return of pain
- Depending on the movement of stone, the pain can vary and the patient canaccurately indicate the place of greatest pain that is located a stone
- Appears frequent urination, dysuria, hematuria, oliguria
- nausea and vomiting
Pain in renal colic is divided into three phases:
Acutephase.In most cases occur at night or early morning.The pain is permanent, although there may be short periods of sharp increase.Pain of maximum intensity and half to six hours.
Permanent phase.Typically lasts from one to four hours, but can continue to twelve hours.Most people during this time is usually treated for honey.help.
phase of extinction.Usually lasts from one to three hours.Pain during this phase are less pronounced
Treatment is primarily aimed at the elimination of obstruction and the elimination of pain.At home, in addition to the introduction of muscle relaxants, to treat renal colic is unacceptable.
The hospital prescribed painkillers (promedol, baralgin, droperidol, analgin, tramadol, maksigan, procaine, etc.), Antispasmodics (most Nospanum, papaverine hydrochloride, atropine sulfate, spazmoverin, Halidorum, aminophylline, etc..) Andintramuscularly (in severe cases intravenously) administered various lytic mixture.For pain relief is used diclofenac sodium.
also shown in renal colic: carrying thermal procedures (hot water bottles on the abdomen and lower back, and hot baths), the men held novocaine blockade of the spermatic cord and in women intrapelvic blockade or embargo round ligament.
However, heat treatments are categorically counter for holding the elderly, with the presence of tumors of any localization, with cardio - vascular insufficiency, micro / gross hematuria.
In case of failure of conservative treatment resort to surgery.
Indications for surgery:
- Close-occlusive stone
- Obstructive Anuria
- Acute suppurative pyelonephritis
- Renal colic with the presence of a single kidney