Author: Atif Latif / Editor: Jason Kendall / Reviewer: Michael Perry / Codes: SLO1, UC2, UP5 / Published: 14/05/2022

A 32-year-old man presents to the Emergency Medicine (ED) and gives a history of left sided loin to groin pain over the last 48 hours getting worse in the last few hours, associated with vomiting.

On examination he looks in marked pain; although he is clinically dehydrated, his physiological observations are normal; he has left flank tenderness. His urine dipstick showed microscopic haematuria. His renal function is: urea 9 and creatinine of 150.

He continues to have marked pain despite analgesia.

His CT is shown:

COW - Uteric colic

You diagnose ureteric colic with possible obstruction.