1
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S11_F2.jpg"}},{"insert":"\n\n"},{"insert":"Paul is a 21-year-old college athlete.\n\nHe developed left sided abdominal pain a couple of hours ago, along with other clinical features highly suggestive of urolithiasis.\n\nPain management has already been initiated, and a series of basic investigations performed.\n\nYou quickly review his complete blood count, which is normal, and urinalysis, which shows 10 to 15 red cells (normal: 0-4) per high powered field, with no pus cells, and negative nitrite and leukocyte esterase tests.\n\nHis serum creatinine is 0.7 mg\/dL (normal: 0.5-1.5) and blood urea nitrogen (BUN) is 12 mg\/dL (normal: 7-20).\n\nAn X-Ray KUB was performed as well, but does not reveal any stones in the urinary tract.\n\nHowever, an ultrasound scan has identified features suggestive of left-sided ureteric obstruction, with moderate hydronephrosis.\n\nThis prompted the team at the emergency department to send the patient over to your unit, for further management of suspected urolithiasis.\n"}]}