Renal colic is a complex of symptoms that develop when there is an outflow of urine from the kidney, characterized by sharp pain. The accumulation of urine overstrains the urinary tract, increases internal pressure, provokes a piercing pain.
Renal colic
The international classification of ICD-10 designates renal colic with code N23.The phenomenon is provoked by the stretching of the renal calyxes with accumulated urine, develops with obstruction of the ureter, inability to excrete urine.
Fluid pressure in the renal pelvis from 15 mm of water.increases by up to 10 times. Urine enters the adipose tissue of the kidney, causing inflammation. With a favorable course of attack, stones, sand are removed, the acuteness of colic subsides.
Causes of
The high risk of renal colic in people with pathologies of the kidney structure, proliferation of tumors of neighboring organs. An attack can be provoked by an adenoma, a tumor of the prostate.
Causing colic can vascular diseases, congestion in the veins of the pelvis, thrombosis, trauma.
Disruption of urinary excretion is provoked:
- Urolithiasis;
- Hydronephrosis;
- omission of the kidney;
- Spasm of ureter;
- Kidney Tuberculosis;
- Tumors;
- Allergies.
The following urine indicators predispose the appearance of stones:
- an increased amount of Ca;
- increase in the content of uric acid;
- appearance of oxalates;
- decrease in the concentration of citric acid compounds.
Increases the likelihood of colic in the treatment of thiazide diuretics, glucocorticosteroids. The renal colic is associated with physical overload, a large volume of drunk fluid.
On the video about the causes of renal colic:
Symptoms of
There can be an attack at any time, regardless of whether the patient is at rest or moves. The leading symptom of renal colic is dagger piercing pain in the lower back, which arises sharply against a background of well-being, lasts from 15 minutes to 18 hours.
Pain localization depends on the place of obstruction of the urinary tract:
- When the pelvis is blocked, the pain is felt in the waist, gives in the back under the lower ribs, abdomen, rectum;
- Obstruction in the ureter is accompanied by pain in the lower back, giving off in the groin, the genitals;
- The occlusion of the ureter at the mouth is caused by pain in the back, perineum.
Acute pain causes a person to rush about in search of a posture, in which the cutting senses stop even a little. Pain pains a person throughout the attack until help is given.
In addition, to stop pain in the lesion of the right kidney is possible only after the possibility of appendicitis is excluded. Self-medication in this situation can cost lives.
Seizures may follow one after another, which may indicate the advancement of a fairly large stone along the urinary tract. Dull pain sometimes does not leave a person even after the end of the attack, but it does not prevent the patient from living a normal life, and with proper treatment completely passes.
Colic phases
How long will the renal colic last, depends on the development phase:
- acute pain - lasts from 1 to 4 hours;
- constant pain - can last up to 12 hours;
- fading pain - the subsidence of the attack lasts about 3 hours, when the patient falls asleep with anesthetics or exhaustion.
Common signs characteristic of colic in adults and children:
- unilateral / bilateral back pain;
- pain in the perineal region;
- frequent urination;
- decrease in the volume of urine, its complete absence;
- nausea;
- decreased intestinal tone;
- flatulence;
- desires for defecation;
- tachycardia;
- temperature.
Nausea is a characteristic symptom of renal colic. The nausea can not be stopped even if it causes vomiting. It explains the nausea of an increasing intoxication of the body caused by a violation of urine outflow, as well as irritation of the renal and solar plexus, interconnected.
Colic in children and adults
Children with renal colic can not clearly indicate where the pain is felt more strongly. It evenly spreads on the back, lower abdomen, gives to the navel. The duration of pain is usually limited to 10-15 minutes, the pain does not reach the same intensity as in adults.
The peculiarity of renal colic in women, especially in pregnant women, is the similarity of symptoms with signs of rupture of the fallopian tubes. At pregnancy at an acute attack the tonus of a uterus raises that threatens with a miscarriage. In men, pain extends to the groin, scrotum, strengthening in the region of the penis.
With prolonged colic develop shock, manifested:
- then;
- pressure drop;
- pallor of the skin;
- bradycardia.
The seizure is allowed with a copious discharge of urine with an admixture of blood, which appears when the small blood vessels of the kidney cups are ruptured.
Diagnosis
The urologist gets quite an objective picture already during the examination. There is a soreness of the lumbar with palpation of the affected kidney, a positive reaction to the beating on the costal arch.
By changing the composition of urine, a complete picture of the attack can not be imagined, since with complete blockage of the ureter, urine comes from a healthy kidney.
With renal colic in urine observed:
- appearance of protein - proteinuria;
- increase in leukocytes;
- appearance of red blood cells.
Laboratory testing for renal colic includes:
- blood sampling for general analysis;
- urine collection for general, biochemical, bacterioscopic examination;
- kidney ultrasound;
- chromocystoscopy - a study consisting in the introduction of a vein of a coloring substance, which in 4 minutes should appear in the mouth of the ureter with normal patency;
- urography - allows to reveal the nature of violations.
Differential diagnosis is performed with an attack of appendicitis, a stomach ulcer, intestinal obstruction, radiculitis. In men, colic is differentiated from an attack of epididymitis, the twisting of seminal coils. In women, symptoms similar to renal colic occur when the cyst is bent on the leg of the ovary, ectopic pregnancy.