Stone come down from pelvis of the kidney & may get impacted at any site of anatomical narrowing of ureter , namely :
1. Pelviureteric junction
2. Crossing of the iliac artery
3. Crossing of the vas deferens or broad ligament .
4.Site of the entry into the bladder wall .
5. Ureteric orifice .
This may lead to hydroureteroneohrosis ,renal parenchymal atrophy ,infection & pyonephrosis .
Clinical features :
1.Pain in the loin radiating to groin . Pain in severe , coliky , intolerable & lasts for few hours .When stone descends into the lower ureter , pain radiates to the tesicles ,labia majora & upper portion of the thigh .It is relieved by narcotics & NSAID .
2.An attack of haematuria or pyuria .
3. Guarding & rigidity of the abdominal wall if present on the right side , it is confused with acute appendicitis .
Investigations :
1. Blood urea & creatinine to rule out renal failure .
2. Plain x-ray KUB :
To diagnose stones 90% of the renal stones are radio opaque .
Enlarged renal shadow can be made out .
3. USG :
Diagnosis of the stone & size can be made out .
Exact location of stone can be made out .
Can confirm the enlarged kidney due to dilatation of collecting system
4.IVP :
To locate the stone exactly in relation to the kidney & ureter & to assess the renal function .
5.Urine culture & sensitivity .
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