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  • Renal colic symptoms

    Colonic is called a strong attack of sharp cramping pains in the abdominal cavity. Colic is divided into intestinal, renal and hepatic.

    Symptoms: suddenly started sharp, cramping pain in the abdomen. Sometimes accompanied by vomiting and chills.

    What's going on? Hepatic and renal colic is most often caused by stones in these organs;intestinal colic occurs with fecal calculi and some diseases, as well as stretching of individual parts of the intestine with gases. Colic can also be with appendicitis. Colic causes a persistent spasm of muscles. The cause of this muscular spasm is most often acute swelling and irritation of the inflamed mucosa. Colic can provoke fatty and spicy food, food and chemical poisoning, and also strong shaking, for example, when driving fast on a broken road.

    In case of an attack of colic, it is necessary to urgently call a doctor and do not take painkillers!

    What should I do? In all cases, colic should immediately call an "ambulance", stay calm and refrain from taking medications before the doctor comes, as painkillers and other means can complicate the diagnosis and provoke a complication.

    Renal colic is the most common symptom of urolithiasis and occurs when the stone that enters the ureter closes its lumen. More details about the symptoms with kidney stones look here. Refers to the emergency conditions that occur with kidney disease.

    A sharp violation of the outflow of urine leads to an increase in pressure in the renal pelvis, dilatation of the renal capsule and the appearance of an attack of pain. Pain in renal colic is localized in the lumbar region( right or left), are acute, spread throughout the ureter to the groin and genitals. Often, with renal colic, there are dysuric disorders and macrohematuria, and in some cases - reflex nausea, vomiting, fever. During an attack of renal colic, patients are restless, trying to find a comfortable position without success.

    Causes of the onset

    Causes of renal colic: stones, swelling, blood clots, mucus, pus, which suddenly clog the lumen of the urinary tract and disrupt urinary excretion, blockage of the ureter, renal pelvis, leading to renal colic. It is observed with stones, tuberculosis, purulent processes in the kidney, neoplasms of the kidney and ureter. Following the acute development of obstruction of the upper urinary tract, there is an increase in pressure inside the kidney, then there is a disorder of blood circulation, sharply developing edema of the kidney.

    Renal colic is characterized by an attack of acute pain in the waist and lateral parts of the abdomen, the pain gives to the inner surface of the thigh, the groin and the genitals. Renal colic can occur at any time of the day, the attack occurs suddenly, develops very quickly. Pain sharp, bursting, the return of pain depends on the location of the stone in the urinary tract. With a stone that caused a blockage of the pelvis, pain is given to the lower back and the hypochondrium. The stone on the border of the upper and middle third of the ureter causes pain, which gives to the lower abdomen, to the navel. With a stone in the area of ​​the nameless line, the pain extends mainly over the front surface of the thigh and into the suprapubic region. With the location of the stone in the caucasal part of the ureter, pain in men is given to the scrotum, in women - to the large labia.

    As the pain of renal colic increases, it is often accompanied by vomiting, intestinal paralysis, which occur almost simultaneously. With renal colic there is a slowdown in heart rate, with other diseases, as a rule, on the contrary, the frequency of cardiac contractions is increasing. At the height of renal colic there is moderate arterial hypertension. Sometimes the pain causes an unconscious condition. The patient's behavior is restless: he rushes, can not find a position in which the pain decreases. Violation of urination is characteristic, but unstable. With effleurage on the lumbar region there is aching pain. In the presence of a single kidney, the excretion of urine can completely stop. The tongue is covered with white bloom in case of renal colic. The stomach, even with intestinal paralysis, participates in the act of breathing. Often, with renal colic, there are signs characteristic of acute diseases of the abdominal cavity. More than half of the cases of renal colic are accompanied by an increase in body temperature. When studying the kidneys sometimes it is possible to determine its increase and soreness. In renal colic, which is caused mainly by obstruction of the upper urinary tract, the composition of urine at the height of renal colic is always normal, since the urine of the second healthy kidney is practically being studied. After relief of renal colic in the urine, the following changes are found: it contains protein, white blood cells and blood. If the blood in the urine appears after the renal colic, then this indicates the presence of a stone pelvis or ureter. If the blood in the urine appeared at the very beginning of the renal colic and then the attack of pain sharply increased, then it speaks of the tumor process in the kidney, pelvis, ureter, in which case colic is caused by clotting of the upper respiratory tract with blood clots. There is a moderate increase in urea in the blood. The duration of an attack of renal colic varies from a few minutes to several hours.

    Diagnosis

    The diagnosis of renal colic is established by a typical pain attack. Often, the typical restless behavior of the patient allows you to suspect renal colic. Confirms the renal colic excretory urography and chromocystosis, which reveal a violation of kidney function and evacuation of urine. Timely allocation within 3-5 minutes of intravenous injection of 0.4% solution of indigo carmine in an amount of 5 ml allows you to abandon the hypothetical diagnosis of renal colic. A survey X-ray reveals shadows of stones. Diagnostic difficulties arise when "invisible" uric acid stones are identified. However, stones of any chemical composition, with a minimum diameter of 0.15 cm, are clearly detected by ultrasound scanning. Behind the stone there is an "acoustic shadow", the appearance of which is due to the complete reflection of ultrasonic waves in its dense structures. To identify uric acid stones allows computed tomography. Excretory urography is especially indicated in cases when there is a need for surgical intervention( concrement of large size, doubt in the presence of the kidney, its functional capacity).In the excretory urogram, there is no contrast in the kidney on the side of the lesion.

    Renal colic must be differentiated from acute cholecystitis if pain is in the right hypochondrium, but with hepatic colic, the pain is bestowed in the area of ​​the nipple of the right breast, in the right scapula, in the right shoulder, in the neck;intensify with inspiration and palpation of the gallbladder. With a slight beat on the right costal arch, the pain intensifies, which is not observed with renal colic.

    Chromocystoscopy allows differentiating diseases. Differentiating kidney colic and acute appendicitis can be difficult. With acute appendicitis, pain usually occurs in the epigastric region, and then in the right ileal region, where the palpitation of the muscles of the anterior abdominal wall is determined by probing, and a slight swelling of the abdomen. But with renal colic the pain syndrome is more pronounced, the pain is more typical, unlike the patient's excited behavior in renal colic, patients with severe pain in the abdominal region are forced to remain immobile, take a forced, sparing position in bed. With acute appendicitis, vomiting appears after a long time after the onset of pain, and with renal colic these signs appear almost simultaneously. If in acute renal colic can not completely eliminate acute appendicitis, then the surgeon is forced to resort to surgery.

    The distinction with intestinal colic is based on the concentration of pain and their persistent character for the period of the attack, the absence of large breaks between each contraction and a pronounced bloating. With renal colic, the intensity of pain is much higher.

    There may be difficulties in the differential diagnosis of intestinal obstruction and renal colic. This is explained by the fact that with renal colic paralysis of the intestine can be pronounced. Such signs as lack of stool, non-occurrence of gases, sharp pains throughout the abdomen, can be observed with renal colic, although they are characteristic for intestinal obstruction. Not always there may be signs characteristic of intestinal obstruction. Vomiting is characteristic of both intestinal obstruction and renal colic. With difficulties in recognizing renal colic and intestinal obstruction, additional methods of investigation are needed: chromocystoscopy. Paralysis of the intestine with renal colic differs from intestinal obstruction by the fact that with the last pain, painful, uninterrupted, seize the entire abdominal area, with a preserved, but perverted peristalsis. Patients are in a state of severe intoxication, the face is drained, the cheeks are sunken. With intestinal obstruction, the stomach is heavily swollen. In cases of high obstruction, vomiting with intestinal contents may occur.

    First aid for renal colic: thermal procedures( hot bath or waist and stomach warmers), injections of narcotic and anesthetic drugs, novocaine blockade of the spermatic cord in men and blockade of the round ligament of the uterus in women or an intra-tubal blockade according to Shkolnikov. If these measures are unsuccessful, the ureter is catheterized to restore urinary excretion.

    In some cases: a stone of large dimensions, complications in the form of acute purulent pyelonephritis, stone destruction operations are performed. After elimination of renal colic, a detailed urological examination is necessary.

    First aid for renal colic:

    • application of heat( warmers on the lumbar region or hot bath with a temperature of 38-39 ° C for 10-20 minutes).This helps to eliminate spasm of the ureters, to stop pain, and sometimes promotes the removal of the stone;

    • injections of antispasmodic drugs: no-shpy, baralgina;cholinolytics - atropine, in necessary situations and narcotic analgesics - promedola.

    1. Raspberry( leaves) - 20 g, birch( branches) - 100 g, cotton grass( grass) - 10 g, cuff( leaves) - 10 g.

    Brew the whole mixture for baths in 5 liters of boiling water in enameled dishes. Wrap for an hour, then strain and pour into a bath. The water level in the bathtub should be just above the waist.

    2. For pain in the liver and its tumors, 1/4 cups of good olive oil should be mixed with 1/4 cup of grapefruit. To drink it it is necessary for the night, not earlier than in 2 hours after meal, preliminary having made an enema. Then go to bed on your right side. In the morning, repeat the enema. This can be done after 4-5 days again, as needed.