Ureteral calculus presenting as generalized abdominal cramps.

We describe a 58-year-old man with a left ureteral calculus who presented with normal-looking urine, generalized abdominal cramps and abdominal distension that was thought to be due to acute intestinal obstruction. The diagnosis of ureteral calculus was established with an abdominal radiograph and a nonenhanced helical computed tomography of the abdomen, and the symptoms were promptly relieved by extracorporeal shock wave lithotripsy. Physicians should be vigilant that ureteral calculus may, although very rarely, present with generalized abdominal cramps.