How is flank pain associated with nephrolithiasis/kidney stones characterized?

Updated: Dec 11, 2019
  • Author: Bradley C Gill, MD, MS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Answer

Flank pain is the classic presenting symptom of urinary calculi and is the predominant cause of flank pain in the absence of fever. Nephrolithiasis is becoming increasingly common in the industrialized world and the amount of healthcare utilized to treat these patients is growing accordingly. Flank pain from nephrolithiasis can result from marked dilation of the proximal urinary tract as well as local inflammation and possible ischemia. In some settings, renal colic pain rarely, if ever, occurs without obstruction.

Classic renal colic is described as crampy flank pain radiating downward to the groin and is often accompanied by nausea and vomiting. On examination, flank palpation and percussion often confirm the pain. Hematuria and pyuria are often present and may result from scraping and irritation of the urinary tract by the stone, although a urine culture in this setting is needed to rule out infection.


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