Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe, colicky flank pain radiating to the groin, associated with nausea and vomiting. Symptoms are refractory to oral analgesics. No history of fever or chills. Patient reports gross hematuria. Imaging confirms a proximal ureteral calculus measuring >10mm.
Clinical Examination Findings
Vitals: Stable, afebrile. Abdomen: Soft, non-distended, positive left/right costovertebral angle (CVA) tenderness. Bowel sounds present. No signs of peritonitis. Genitourinary: No palpable bladder distension.
Treatment Protocol
Due to calculus size >10mm, spontaneous passage is unlikely. Plan: Admission for pain control and hydration. Urgent surgical intervention indicated: Ureteroscopy (URS) with laser lithotripsy or Retrograde Intrarenal Surgery (RIRS) vs. Double-J (DJ) stent placement. Prophylactic antibiotics initiated.