RENAL KOLİK, TANI VE TEDAVİSİ

Yıl 2008, Cilt: 21 Sayı: 2, 187 - 192, 24.06.2015

Ahmet Müslümanoğlu Abdulkadir Tepeler

Öz

Akut renal kolik acil servislerde en sık karşılaşılan, en ağrılı ürolojik acillerden biridir. Bir kişinin tüm yaşamı boyunca renal kolik atağı geçirme riski % 1-10 arasındadır. Flank ağrısının ayırıcı tanısında böbrek ve üreter taş hastalığı ilk sırada yer alırken, aynı semptom ve bulguları sergileyen pek çok antite vardır. Noninvaziv radyolojik tekniklerin gelişmesiyle renal kolik tanısında farklı yöntemler kullanılmaktadır. Bu derlemede, renal kolik patofizyolojisi, tanısı ve tedavisi hakkında son gelişmeler sunulmaktadır.

Anahtar Kelimeler: Akut renal kolik, tanı, tedavi

Anahtar Kelimeler

-

Kaynakça

• Jeremy B. Diagnostic and treatment patterns for renal
• colic in US Emergency Departments. Int Urol
• Nephrol. 2006; 38(1): 87-92.
• Thakore S, McGuan EA and Morrison W.Emergency
• ambulance dispatch: is there a case for triage? J R Soc
• Med. 2002; 95: 126-129.
• Lammers R, Roth BA, Utech T.Comparison of
• ambulance dispatch protocols for nontraumatic
• abdominal pain. Ann Emerg Med 1995; 26: 579-585
• Shokeir AA. Renal colic: pathophysiology, diagnosis
• and treatment. Eur Urol 2001; 39: 241-249.
• Anderson KR, Smith RC. CT for evaluation of flank
• pain. J Endourol 2001; 15: 25-29
• Bihl G, Meyers A. Recurrent renal Stone disease:
• advances in pathogenesis and clinical management.
• Lancet 2001; 358: 651-656
• Moody TE, Vaughan ED Jr, Gillenwater JY.
• Relationship between renal blood flow and ureteral
• pressure during 18 hours of total ureteral occlusion.
• Invest Urol 1975;13: 246-251
• Lanzone JA, Gulmi FA, Chou S, et al. Renal
• hemodynamics in acute unilateral ureteral obstruction:
• contribution of endothelium-derived relaxing factor. J
• Urol 1995; 153: 2055-2059
• Reyes AA, Klahr S. Renal function after release of
• ureteral obstruction: role of endothelin and renal
• artery endothelium. Kidney Int 1992;42: 632-638
• Eskelinen M, Ikonen J, Lipponen P. Usefulness of
• history-taking, physical examination and diagnostic
• scoring in acute renal colic. Eur Urol 1998; 34: 467-
• -
• Hamm M, Wawroschek F, Weckermann D, et al.
• Unenhanced helical computed tomography in the
• evaluation of acute flank pain. Eur Urol 2001; 39:
• -465
• Patlas M, Farkas A, Fisher D, et al. Ultrasound vs CT
• fort he detection of ureteric Stones in patients with
• renal colic.Br J Radiol 2001; 74: 901-904
• Platt JF, Rubin JM, Ellis JH. Acute renal obstruction:
• evaluation with intra-renal duplex Doppler and
• conventional US. Radiology 1993; 186: 685-688
• Shokeir AA, Abdulmaaboud M. Prospective
• comparison of nonenhanced helical computerized
• tomography and Doppler ultrasonography fort the
• diagnosis of renal colic. J Urol 2001; 165:1082-1084
• Shokeir AA, Abdulmaaboud M, Farag Y, Mutabagani
• H. Resistive index in renal colic: the effect of
• nonsteroidal anti-inflammatory drugs. BJU Int 1999;
• : 249-251
• Meagher T, Sukumar VP, Collingwood J, et al. Low
• dose computed tomography in suspected acute renal
• colic. Clin Radiol 2001; 56: 873-876
• Krishna NS, Morrison L, Campbell C. Is spiral
• computed tomography the imaging modality of choice
• for renal colic? Postgrad Med J 2001; 77: 124-132
• Thomson JM, Glocer J, Abbot C, et al. Computed
• tomography versus intravenous urography in
• diagnosis of acute flank pain from urolithiasis: a
• randomized study comparing imaging costs and
• radiation. Australas Radiol 2001; 45: 291-297
• Rekant EM, Gibert CL, Counselman FL. Emergency
• department time for evaluation of patients discharged
• with a diagnosis of renal colic: enhanced helical
• computed tomography versus intravenous urography.
• J Emerg Med 2001; 21: 371-374
• Amis ES Jr. Epitaph for the urogram. Radiology
• ; 213: 639-640
• Dalla Palma L. What is left of i.v.urography? Eur
• Radiol 2001; 11: 931-939
• Tiselius HG, Ackermann D, Alken P, et al. EAU
• Guidelines on Urolithiasis, 2007; 22-23
• Evans HJ, Wollin TA. The menagement of urinary
• calculi in pregnancy. Curr Opin Urol 2001; 11: 379-
• -
• Spencer JA, Tomlinson JA, Weston MJ, Lloyd SN.
• Early comparison of breath-hold MR excretory
• urography, Doppler ultrasound and isotope
• -
• Marmara Medical Journal 2008;21(2);187-192
• Ahmet Yaser Müslümanoğlu, Ark.
• Renal kolik, tanı ve tedavisi
• renography in evaluation of symptomatic
• hydronephrosis in pregnancy. Clin Radiol 2000; 55:
• -453
• Sudah M, Vanninen R, Partanen K, et al. MR
• urography in evaluation of acute flank pain: T2-
• weighted sequences and gadolinium-enhanced treedimensional
• FLASH compared with urography. AJR
• Am J Roentgenol 2001; 176: 105-112
• Miralles R, Cami J, Gutierrez J et al. Diclofenac
• versus dipyrone in acute renal colic: A doule-blind
• controlled trial. Eur J Pharmacol 1987; 33: 527-528
• Al-Wailli NSD. Intramusculer tenoxicam to treat
• acute renal colic. Br J Urol 1996; 77: 15-16
• Perlmutter A, Miller L, Trimble LA et al. Toradel, a
• NSAID used for renal colic, decreases renal perfusion
• and ureteral pressure in a canine model of unilateral
• ureteral obstruction. J Urol 1993; 149: 926-930
• Brater DC. Effects of nonsteroidal anti-inflammatory
• drugs on renal function: focus on cyclooxygenase 2-
• selective inhibition. Am J Med 1999; 107: 65S-70S
• Nakada SY, Jerde TJ, Bjorling DE, Saban R.
• Selective cyclooxygenase-2 inhibitors reduce ureteral
• contraction invitro: a better alternative for renal colic.
• J Urol 2000; 163: 607-612
• Cohen E, Hafner Z, Rotenberg Z, Fadilla M, Garty M.
• Comparison of ketorolac and diclofenac in the
• treatment of renal colic. Eur J Clin Pharmacol 1998;
• : 455-458
• Altay B, Horasanlı K, Kendirci M ve ark. Renal kolik
• tedavisinde piroksikam hızlı çözünen dilaltı tablet
• formunun, intramusküler piroksikam ile çift kör,
• randomize, plasebo kontrollü karşılaştırılması. Türk
• Üroloji Dergisi 2003; 29(4): 460-464
• Brenner PC: Urological trauma and emergencies. In:
• Fulde GWO, ed. Emergency Medicine: The principles
• of Practice. Sydney::Churchill Livingstone, 2004,
• -214
• Holdgate A, Carissa MOH. Is there a role for
• antimuscarinics in renal colic? A randomized
• controlled trial. J Urol 2005; 174: 572-575
• Malin JM Jr, Deane RF, Boyarsky S. Characterisation
• of adrenergic receptors in human ureter. Br J Urol
• ; 44: 171-174
• Yılmaz E, Batislam E, Basar M.M., et al.The
• comparison and efficacy of 3 different α1-adrenergic
• blockers for distal ureteral stones.J Urol 2005; 173:
• -2012
• Lee Y, Lee W, Chen M, et al. Acupuncture in
• treatment of renal colic. J Urol 1992; 147: 16-18
• Bajwa ZH, Gupta S, Warfield CA, Steinman TI. Pain
• management in polycystic kidney. Kidney Int 2001;
• : 1631-1644
• Mora B, Giorni E, Dobrovits M et al. Transcutaneous
• electrical nerve stimulation: an effective treatment for
• pain caused by renal colic emergency care. J Urol
• ; 175: 1737-1741
• Nikiforov S, Cronin AJ, Murray WB, Hall VE.
• Subcutaneous paravertabral block for renal colic.
• Anesthesiology 2001; 94: 531-532