A 52-year-old male presented to the emergency department with severe right flank pain radiating to the right lower quadrant. His blood pressure was 154/96, pulse rate was 79 bpm, respiratory rate was 24 breadths per minute and temperature was 36.7° C. The pain was insidious in onset and had an intensity of 10/10 on verbal analog scale which decreased to 8/10 after administration of Toradol and Morphine medications provided in the emergency department. The pain was constant, lasting 3 hours in duration, and he had two episodes of emesis since its onset.
Physical examination: His abdomen was soft with diffuse tenderness which increased over the right lower quadrant. Urinalysis revealed a moderate increase in specific gravity (1.030), significant hematuria (3+) and a trace of protein. Diagnostic imaging: A right ureteric calculus was apparent on a conventional abdominal radiograph (fig.…
