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Ureteral calculus presenting as generalized abdominal cramps.
Alexander K C Leung1, Wm Lane M Robson, Anthony Chi Fai Ng
1The University of Calgary, Alberta, Canada. aleung@ucalgary.ca
Journal of the National Medical Association
|August 3, 2007
Summary
Ureteral calculus, a kidney stone in the ureter, can rarely mimic intestinal obstruction with generalized abdominal cramps. Prompt diagnosis via imaging and treatment with extracorporeal shock wave lithotripsy resolved the patient's symptoms.
Area of Science:
- Urology
- Nephrology
- Gastroenterology
Background:
- Ureteral calculi (kidney stones in the ureter) are common causes of acute abdominal pain.
- Typical symptoms include flank pain radiating to the groin, hematuria, and urinary urgency.
- Atypical presentations can pose diagnostic challenges, potentially delaying appropriate management.
Observation:
- A 58-year-old male presented with generalized abdominal cramps and distension.
- Initial clinical suspicion was acute intestinal obstruction due to the absence of urinary symptoms and normal urine appearance.
- The patient's presentation mimicked a non-urological emergency.
Findings:
- Abdominal radiography and nonenhanced helical computed tomography (CT) confirmed a left ureteral calculus.
- The diagnosis of ureteral calculus was established despite the atypical presentation.
- Extracorporeal shock wave lithotripsy (ESWL) provided prompt symptomatic relief.
Implications:
- Physicians must maintain a high index of suspicion for ureteral calculus even with atypical presentations like generalized abdominal cramps.
- Diagnostic imaging, including CT, is crucial for identifying ureteral calculi presenting as non-urological emergencies.
- Early diagnosis and treatment of ureteral calculi can prevent complications and improve patient outcomes.
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