Audio_Uro_Hp_10

HISTORY: The patient is a 55-year-old woman who was seen at your request. On May 21, 2006, and June 1, 2006, she developed right-sided lower quadrant abdominal pain for which she went to the emergency room. After CT scan was performed, the patient received pain medications and she was discharged. She does not have any gross hematuria. She continues to have slight right lower quadrant tenderness. There is no previous history of nephrolithiasis.

PAST MEDICAL HISTORY: Fibromyalgia, chronic back pain, and hypertension

PAST SURGICAL HISTORY: Laminectomy, hysterectomy.

ALLERGIES: None.

SOCIAL HISTORY: Non-smoker.

FAMILY HISTORY: The patient does have family history of nephrolithiasis.

LABORATORY DATA: Urinalysis showed calcium oxalate crystals. BUN 18, creatinine 0.9. CT scan was performed twice in the hospital and the first time was with IV contrast. CT scan showed stranding of the right renal pelvis and around the right ureter but no evidence of obstruction was noted. Mild hydronephrosis was seen on the second CT scan.

PHYSICAL EXAMINATION: The patient was in no acute distress and is alert, awake and oriented. There was no CVA tenderness. The abdomen was soft but slight right lower quadrant tenderness was noted. There was no inguinal adenopathy or inguinal hernia.

IMPRESSION AND PLAN: Since the contrast scan obscured the view of stones, she will be sent for non-contrast CT scan of the abdomen and pelvis. She will be seen in followup after her CT scan. She was encouraged to drink plenty of fluids.