Initial management

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