Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe, colicky flank pain radiating to the groin, associated with hematuria, nausea, and occasional vomiting. No history of fever or chills. Symptoms consistent with obstructive uropathy secondary to suspected calcium oxalate nephrolithiasis.
Clinical Examination Findings
Patient appears in acute distress, writhing in pain. Abdomen: soft, non-distended, positive for unilateral costovertebral angle (CVA) tenderness. Bowel sounds present. No signs of peritonitis or rebound tenderness.
Treatment Protocol
Initiate aggressive fluid resuscitation, analgesia with NSAIDs (e.g., ketorolac) or opioids as needed, and antiemetics. Medical Expulsive Therapy (MET) with alpha-blockers (e.g., tamsulosin) considered for stones <10mm. Surgical consultation for intractable pain, infection, or renal failure.