Author: Mohomed Ashraf / Editor: Sarah Edwards / Codes: CC5, CC7, CC9, SLO2, SLO3, SuP1 / Published: 14/04/2022
A 36-year-old gentleman presents with left flank pain that has been intermittent for the past few hours.
He describes the pain as sharp over the left flank and says it made him nauseous when it occurred. It gradually improved and he waited to see whether it’d get better but it recurred a few hours later and so presented to the ED. He has been well recently. He denies any dysuria, frequency, gross haematuria.
His observations are as follows: BP 220/110, HR 90 bpm, T: 37 C, RR: 16/min.
He has no past medical history. He takes no medications. He last had a ‘health check up’ for purposes of his work visa around 7 years ago. He is a builder and smokes around 30 cigarettes a day. He consumes around 10 units of alcohol a week – all over the weekend. He states he has been ‘working’ a lot more because his wife has been laid off from her job due to the pandemic and says he thinks his pain was ‘from his back muscles’.
His cardiovascular, respiratory, abdominal and genital exam is entirely normal.
His urine dipstick shows microscopic haematuria but nothing else. His ECG shows a left ventricular strain pattern, his chest X ray looks normal and his U&E reveals an acute kidney injury (AKI stage 2).