Quiz

Case history 

A 31-year-old female presented with sudden onset of severe left loin pain radiating to the left lower abdomen and groin. The pain was constant, with intermittent acute attacks lasting minutes. The patient was nauseated and had vomited once. There were no urinary or bowel symptoms. There had been amenorrhoea for 8 years since starting medroxyprogesterone acetate.

On examination, the patient was afebrile, tachycardic with normal blood pressure. Abdominal examination revealed a soft abdomen with tenderness along the left renal tract, but no guarding, rebound tenderness or masses. Rectal examination revealed stool in the rectum, but no tenderness, masses, mucus or blood. Urinalysis showed a trace of blood. A pregnancy test was negative. Full blood count, urea and electrolytes and liver function test were within normal ranges. A provisional diagnosis of renal colic was made and an intravenous urogram performed.

No full text is available. To read the body of this article, please view the PDF online.