ABSTRACT
This chapter presents a case study of a 30-year-old man who is admitted to the Emergency Department (ED) with a 6-hour history of excruciating right-sided abdominal pain. The pain is over his right flank and comes in waves, with each episode lasting 30-40 minutes; it also occasionally moves towards his groin. He denies dysuria or visible haematuria. He has a history of Crohn's disease and has undergone extensive small bowel resection. The two main aspects of managing nephrolithiasis in the ED are achieving adequate pain control and predicting/facilitating stone passage. In the ED, the key to dealing with a patient who has suspected ureteric colic is to confirm the diagnosis and assess for complications. Confirmation of the diagnosis can be achieved through either a low-dose CT-KUB (kidneys, ureters and bladder) or ultrasound of the urinary tracts; while CT-KUB carries a radiation exposure risk, it has a much higher sensitivity than ultrasound and is generally the test of choice.
