title: Urolithiasis in the emergency department.
abstract: Urolithiasis commonly presents to the emergency department with acute, severe, unilateral flank pain. Patients with a suspected first-time stone or atypical presentation should be evaluated with a noncontrast computed tomography scan to confirm the diagnosis and rule out alternative diagnoses. Narcotics remain the mainstay of pain management but in select patients, nonsteroidal anti-inflammatories alone or in combination with narcotics provide safe and effective analgesia in the emergency department. Whereas most kidney stones can be managed with pain control and expectant management, obstructing kidney stones with a suspected proximal urinary tract infection are urological emergencies requiring emergent decompression, antibiotics, and resuscitation.
authors.affiliation: Department of Emergency Medicine, Washington Hospital Center, Georgetown University, Washington, DC 20007, USA. autumngraham@gmail.com
authors.forename: Autumn
authors.initials: A
authors.lastname: Graham
authors.forename: Samuel
authors.initials: S
authors.lastname: Luber
authors.forename: Allan B
authors.initials: AB
authors.lastname: Wolfson
mesh_terms: D003950:Diagnostic Techniques, Urological / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D006801:Humans; D009017:Morbidity / Q000639:trends; D014481:United States / Q000453:epidemiology; D052878:Urolithiasis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy