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FOCUSED SHIFT VIEW

Flank Pain & Renal Colic

Confirm the stone—but first exclude infected obstruction, AAA, and the surgical mimics.

Open full pathway
Educational first-pass aid. Reassess the patient, confirm doses and use local protocols.

1 · First minutes

  1. Check vital signs, pregnancy status, urinalysis, renal function, and analgesic response.
  2. Look for sepsis or obstruction before choosing outpatient stone care.
  3. Use ultrasound or CT according to risk, first episode, diagnostic uncertainty, pregnancy, and local pathways.

2 · Escalate now if

  • Fever, rigors, hypotension, or toxicity
  • Anuria, solitary kidney, acute kidney injury, or bilateral obstruction
  • Uncontrolled pain or vomiting
  • Older patient with vascular risk or hypotension
  • Pregnancy with pain or bleeding

3 · Immediate workup

  • Urinalysis, pregnancy test when relevant, creatinine
  • POCUS for hydronephrosis and aortic screening when indicated

4 · Don’t miss

  • Infected obstructed urinary system
    Fever/systemic illness plus obstruction requires urgent urology drainage and antibiotics—not outpatient stone management.
  • Ruptured AAA / aortic dissection
    Older patient, hypotension, vascular risk, abdominal/back pain, or pulse deficit: image the aorta.
  • Pyelonephritis with sepsis
    Fever, flank tenderness, shock, or vomiting warrants sepsis treatment and source-control assessment.

5 · Disposition lane

Admit / urology

Infection concern, AKI, refractory symptoms, large/complicated stone, or unreliable follow-up.

Urgent drainage / resuscitation

Septic obstructed system, anuria with obstruction, or vascular catastrophe.