Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe, colicky flank pain radiating to the groin/suprapubic region. Associated symptoms include nausea, vomiting, hematuria, and urinary urgency/frequency. Denies fever, chills, or dysuria. Pain intensity is rated [X]/10, intermittent, and exacerbated by movement.
Clinical Examination Findings
General: Patient appears in acute distress, writhing in pain. Abdomen: Soft, non-distended, bowel sounds present. Tenderness: Significant unilateral costovertebral angle (CVA) tenderness on [Right/Left] side. No rebound tenderness or guarding. Genitourinary: External genitalia normal; no inguinal lymphadenopathy.
Treatment Protocol
1. Analgesia: NSAIDs (e.g., Ketorolac) or Opioids for breakthrough pain. 2. Antiemetics: Ondansetron as needed. 3. Medical Expulsive Therapy (MET): Tamsulosin 0.4mg daily. 4. Hydration: Encourage oral fluid intake (2-3L/day). 5. Follow-up: Strain urine for stone analysis; repeat imaging if symptoms persist or fever develops.