Abdominal Aortic Aneurysm

Renal colic mimics

EMKF

 

  • Some mimics of renal colic that may arrive at the ED include: upper UTI’s, ectopic pregnancies, ovarian torsion, adnexal masses, testicular torsion, acute aortic syndromes, renal artery aneurysms, renal infarction, splenic infarction, bowel obstruction, diverticulitis, appendicitis, biliary colic, cholecystitis, acute intestinal ischemia, pneumonia, pulmonary embolism, retroperitoneal hematoma, iliopsoas abscess.
  • Focused history and physical exam are paramount due to the multitude of structures in the area and potentially dangerous conditions that may mimic renal colic.
  • Flank pain and hematuria are the hallmarks of renal colic, however, the presentation is variable.
  • Diagnosis can be confirmed with CT scan, which will show most other potential items in the differential if the scan is negative for a stone.

 

Serious reasons why your patient fainted…

EMKF

If your patient presents with…

  1. Symptoms of arm ischemia or paresthesias with syncope – Subclavian steal syndrome
  2. Chest pain that is acute, radiates, tearing/sharp, involves symptoms above and below diaphragm with syncope – Aortic dissection
  3. Tachypnea, pleuritic chest pain, shortness of breath with syncope – PE
  4. Neurologic deficit with syncope – TIA/stroke
  5. Headache that is sudden in onset, maximal at onset, worst of life with syncope – Subarachnoid hemorrhage
  6. Minor trauma with head or neck pain and syncope – Carotid/vertebral artery dissection
  7. Abdominal/flank pain in older patient with syncope – Ruptured AAA