Extracorporeal Shock wave Lithotripsy (ESWL) has proved to be effective safe and nowadays is the preferred method of treatment of over 90% of upper urinary tract stones [1,2]. Nevertheless, ESWL is not devoid of complications. Although the majorities are trivial and transient, serious complications could occur but are extremely rare and only very few have been reported in the literature [3]. We report a case of small intestinal perforation following ESWL. The case is striking because we decided to carry out a non-operative management, which in this case turned out to be successful. We are not aware of another such case in the English-language literature.
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