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Initial management

Authoring team

History, Examination, Investigations

  • iv access
    • normal saline or haemacell (if shock)
  • nasogastric tube - if obstruction is suspected
  • analgesia
    • for example, pethidine (not morphine - this is because morphine causes contraction of the sphincter of Oddi (gallstones may aggravate condition e.g. acute pancreatitis)
    • if renal colic then also use a non-steroidal e.g. voltarol
    • an antispasmodic may be useful if colicky pain
  • other procedures
    • give O2 (if patient is breathless)
    • CVP line may be necessary
    • intravenous antibiotics if infection is suspected e.g. diverticulitis

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