A 37 year old man presents with severe left flank pain with radiation into his left testicle. He says he has had no history of similar pain but does recall his father getting similar attacks over the years. He says he can not find a comfortable position and has been vomiting all day.
On examination, he appears to be in severe pain, unable to lie down, and moves constantly. His testicles appear normal and are not tender. His urine shows hematuria but his kidney functions, electrolytes, amylase and lipase are all within normal limits.
At this time you will order:
1. Ultrasound of kidneys
2. KUB plain films of abdomen
3. Helical CT of abdomen with contrast
4. Non-contrast abdominal helical CT
After review of the CT scan of abdomen you have decided that patient needs to be admitted. The reasons you have decided to admit this patient include all of the following except:
1. Bilateral kidney obstruction
2. Evidence of infection without ureteral obstruction or fever
3. Severe pain despite oral analgesics
4. Solitary kidney obstruction
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