Renal Colic by Gastrointestinal Perforation: Endoscopic Approach

Most cases of acute, sharp, flank pain radiating to the scrotum or groin are caused by nephrolithiasis or ureterolithiasis and are commonly referred to as renal colic. Computed tomography (CT) has become a standard imaging technique for uncomplicated renal colic in many countries [1], revealing an alternative diagnosis in up to 6% of the patients [1]. Although rare, gastrointestinal perforation by a foreign body may be associated with hydronephrosis, due to the contiguous inflammatory process, and present itself as flank pain [2]. Fishbone ingestion with bowel perforation is a particularly challenging diagnosis as the presentation may mimic common abdominal pathologies, and patients may not recall the ingestion of a foreign body [3]. The following case highlights the diagnostic difficulties in considering and identifying alternative etiologies