Renal colic

The attack of the acute pain which developed as a result of sudden disturbance of outflow of urine meets at such states:

• Urolithiasis;
• Nephroptosis with an ureter excess;
• Kidney injury;
• Tuberculosis of a renal pelvis;
• Pyelonephritis: acute and chronic – in an aggravation stage;
• Kidney tumor.

Renal colic most often arises at an urolithiasis. Risk factors for its development are the following reasons:

• Sufferings urolithiasis of blood relatives;
• Loss of liquid in an organism – a condition of an eksikoz;
• The long feverish state which is followed by the increased body temperature;
• Diseases of kidneys: pyelonephritis, infections of urinary channels leading to the cicatricial deformation narrowing urinary tract;
• Errors in food, reception of difficult soluble products or medicines.

Renal colic in clinical practice occurs in 10% at men and in 5% of emergencies of a disease at women. The urolithiasis strikes persons of working-age: from 30 to 50 years. In half of cases the attack of an acute pain repeats after a while, that is, has tendency to a recurrence.

Renal colic, development mechanism

At obstruction of a gleam the concrement or a prelum of an ureter outside break an urine passage. It continues to be produced, but as outflow is broken, accumulates in a renal pelvis, causing swelled kidney tissues. Receptors signal about stretching of pyelocaliceal system, the alarm signal gets into a spinal cord, forming the center of an overstrain of receptors. After a while painful impulses reach a cerebral cortex.

Renal colic, symptoms

Irrespective of an emergence source, the main symptom of any colic – the acute (pricking) pain. At damage of abdominal organs pain arises in a stomach and a waist. When renal colic develops, its symptoms differ from pains at gripes of other localization a little.

The nature of pain at damage of urinary tract:

• Suddenness, regularity, skhvatkoobraznost;
• Rather long duration: of several minutes till 12 o'clock;
• Impossibility to accept such position of a body at which pain ceases.

Renal colic at children is followed by emergence of pains in a navel which are followed by fervescence to 37,5 ^°C, vomiting and strong fear.

When there is ureteral occlusion at pregnant women, skhvatkoobrazny character imitates the beginning of patrimonial activity, however at the same time the uterus is in a normal tone, but dysuric manifestations are noted: increase of an urination with small amount of the emitted urine.

Depending on the place of ureteral occlusion, renal colic which symptoms indicate anatomic localization of obstruction of urinary tract gives different synalgias. The "travelling" stone stops in places of narrowings of an ureter, and in each case various prevalence of pain is noted:

• The mouth in the field of a renal pelvis – in average area of an abdominal cavity;
• Decussation with arteries of ileal area – the outside surface of a hip and inguinal area;
• The mouth of a bladder – a stomach bottom;
• In a bladder wall – an urethra.

The arisen renal colic has symptoms not only the mentioning urinary system, but also all organism in general. Obstruction of an ureter is often accompanied by the following manifestations:

• Vomiting;
• Paralytic intestinal impassability;
• Dizziness, unconscious state;
• Increase in blood pressure;
• Infrequent pulse.

Contrary to the standard opinion, the hamaturia (availability of blood in urine) appears only when renal colic is allowed. That is, the stone leaves urinary tract. As a rule, the concrement sizes less than 0,5 cm promote independent department together with the coming-out urine. Stones are found in urine in the form of small sand which department is also followed by an acute pain.

When renal colic develops against the background of cancer, the hamaturia arises at once, along with a back pain.

Renal colic, treatment

At specification of the diagnosis by means of inspection of ultrasonography on the portable sensor, patients are subject to the emergency hospitalization in the following cases:

• Lack of effect of therapeutic actions;
• Development of complications;
• Only kidney or simultaneous defeat of two ureters.

If for the first time there is renal colic, treatment is carried out in a hospital. It is necessary for clarification of the reason of pathology of kidneys. When introduction of spasmolysants and anesthetics has positive effect, do not hospitalize the patient, but data on him transfer to policlinic for outpatient observation.

As Promedolum and its analogs cause strong relaxation owing to which the stone moves ahead on an ureter uncontrolledly, owing to what the volume of operation increases several times, today renal colic is not stopped by narcotic drugs!

For the purpose of removal of acute pains the medicines blocking the main mediators of pain – prostaglandins are entered. Analgetics of non-narcotic action are for this purpose used.

Renal colic, acute management

For rendering a self-care, but not self-treatment, some recommendations which help to endure pain before arrival of "ambulance" are developed. At pains of weak intensity and precisely known diagnosis of an urolithiasis acceptance of a hot bathtub helps. In the absence of conditions for reception of a bathtub when renal colic begins, acute management is limited to reception of a spasmolysant (Nospanum) and applying of a hot hot-water bottle to a waist.

It is desirable to collect before arrival of the doctor urine for the analysis. Timely conducted laboratory research is so important that often will save life to the patient.