Acute pancreatitis caused by extracorporeal shock wave lithotripsy for bilateral renal pelvic calculi

Abé, Hiroyuki; Nisimura, Taiji; Osawa, Shuichi; Miura, Takafumi; Oka, Fumiatsu

doi:10.1046/j.1442-2042.2000.00139.x

Cited by 37 publications

(30 citation statements)

References 4 publications

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“…In this study, 513 (19.4%) developed low-grade fever, which was managed conservatively and graded into category I. A few cases of injuries to spleen and pancreas graded in category IVa have been reported in patients who received SWL to treat renal stones, although these complications are rare and manifestations vary, including death [15,16]. Stomach, duodenum, small and large bowel may be injured during SWL.…”

Section: Discussionmentioning

confidence: 99%

Standardized Grading of Shock Wave Lithotripsy Complications with Modified Clavien System

Mittal¹,

Srivastava

Kappor

et al. 2016

Urol Int

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Introduction: Definitive consensus on grading of complications of shock wave lithotripsy (SWL) does not exist. The objective of this study was to grade complications of SWL in relation to different stone and shock wave parameters, according to the modified Clavien system. Materials and Methods: Complications observed in 2,648 patients who underwent SWL between January 2003 and May 2014 were evaluated statistically and stratified into 5 grades by the modified Clavien system focusing on stone and shock wave parameters. Results: Statistically significant association (p ≤ 0.05) was found between SWL outcome, Clavien grade of complications and stone and shock wave parameters. According to the modified Clavien system, grades I, II, IIIa, IIIb, IV and V complications were observed in 1,811 (68.39%), 619 (23.37%), 183 (6.91%), 34 (1.28%), nil (0.00%) and 1 (0.03%) patients, respectively. The overall success rate at 3 months was 87.72%. Conclusions: The modified Clavien system provides a standardized grading of SWL complications and can be used to standardize procedural errors and maintain quality, thereby preventing associated complications and improving the overall management and hence outcome of SWL.

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Section: Discussionmentioning

confidence: 99%

Standardized Grading of Shock Wave Lithotripsy Complications with Modified Clavien System

Mittal¹,

Srivastava

Kappor

et al. 2016

Urol Int

View full text Add to dashboard Cite

show abstract

“…6 Another hypothesis is that infected urine might leak from the pelvic region and cause pancreatitis after ESWL. In our case, however, results of urinalysis and urine culture were normal.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 In the published literature, many serious complications after ESWL have been reported, including pulmonary contusions, cardiac arrhythmias, gastric erosions, aortic aneurysm rupture, portal and iliac vein thrombosis, psoas abscess, retroperitoneal and brain hemorrhage, biliary obstruction, colonic and splenic injury, small bowel perforation, hepatic hematoma, and pancreatitis. [6][7][8][9][10] Only two reports of severe acute pancreatitis after ESWL exist in the published literature, and the mechanism of pancreatitis is still undetermined. 6,7 Extracorporeal shock wave lithotripsy might cause biliary pancreatitis, especially in patients with a common channel as a result of bile duct obstruction because of fragments of gallstones or common duct stones.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10] Only two reports of severe acute pancreatitis after ESWL exist in the published literature, and the mechanism of pancreatitis is still undetermined. 6,7 Extracorporeal shock wave lithotripsy might cause biliary pancreatitis, especially in patients with a common channel as a result of bile duct obstruction because of fragments of gallstones or common duct stones. 4 Clinicians should be aware of this condition.…”

Section: Discussionmentioning

confidence: 99%

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Acute necrotizing pancreatitis as a rare complication of extracorporeal shock wave lithotripsy

et al. 2006

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Extracorporeal shock wave lithotripsy (ESWL) is considered the standard treatment for most renal and upper ureteral stones. Some centers use ESWL to treat bile duct stones and pancreatic calculi. Although ESWL is generally considered safe and effective, major complications, including acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, rupture of an aortic aneurysm and intracranial hemorrhage, have been reported to occur in less than 1% of patients. Here, we present an extremely rare case of acute necrotizing pancreatitis occurring after ESWL for a rightsided urinary stone, which was treated by non-operative percutaneous interventions.Key words complication, extracorporeal shock wave lithotripsy, necrotizing pancreatitis. Case reportA 39-year-old man was referred to the Department of Urology at the Baskent University Faculty of Medicine for hematuria and right flank pain in May 2004. On computed tomography (CT) scan, the patient was found to have a 4 × 2 mm calculus in the right renal pelvic region. There also were dilatations of the right pelvicaliceal system and the proximal ureter ( Fig. 1). As the obstructing stone was non-opaque, we decided to treat it with extracorporeal shock wave lithotripsy (ESWL). ESWL (Siemens Lithostar Modularis, Siemens Medical Solutions, Iselin, NJ, USA) was performed with 3500 shocks at 15 kv. The procedure was uneventful. However, 6 h later, the patient complained of gradually increasing, serious abdominal and back pain, and was referred to general surgery.On physical examination, the patient's abdomen showed muscular defense and distension. Bowel sounds were hypoactive. The patient has neither history of biliary lithiasis nor chronic alcohol consumption. Laboratory data demonstrated an elevated white blood cell level of 21 × 10 3 /µL, serum amylase level of 3903 U/L (normal range, 30-110 U/L), and serum lipase level of 9250 U/L (normal range, 13-60 U/L). Liver function tests of transaminases, bilirubin, gama glutamyl transferase, lactic dehydrogenase were all in normal laboratory ranges. Serum calcium and parathormone levels were also normal. Results of abdominal and chest radiographs were normal and without signs of bowel perforation or obstruction. An abdominal CT scan was performed and demonstrated parenchymal edema of the pancreas. In addition, there were small areas of necrosis (25 × 24 mm) on the corpus and tail regions of the organ (Fig. 2). Intraabdominal fluid in perirenal, peripancreatic and pelvic regions was also determined. The gallbladder, and intrahepatic and extrahepatic biliary systems were completely normal. Also, a residual millimetric stone on the right renal pelvis with minimum pelvic dilatation was seen, suggesting that the lithotripter had been focused on the target stone correctly.The International Symposium on Acute Pancreatitis in 1992 defined pancreatic necrosis as the presence of one or more diffuse or focal areas of non-viable pancreatic parenchyma, 1 so based on the patie...

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“…Therefore, these authors concluded that there is no clinically apparent di erence in the long-term e ect on renal function for patients with bilateral renal calculi treated with ESWL in a simultaneous versus staged fashion. Physicians caring for spinal cord injury patients should however remember that serious complications such as irreversible acute renal failure, 9 and acute pancrea- Figure 4 Following insertion of a stent in the right ureter, the ureteric calculus has been pushed in to the renal pelvis titis 10 have been reported after bilateral ESWL. An important consideration, which must be made, is that the risk of ureteric obstruction due to stone fragments must be minimal.…”

Section: Simultaneous Versus Staged Eswl Of Bilateral Renal Calculimentioning

confidence: 99%

Bilateral extracorporeal shock wave lithotripsy in a spinal cord injury patient with a cardiac pacemaker

et al. 2001

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Objectives: To review the precautions to be observed before and during extracorporeal shock wave lithotripsy (ESWL) in spinal cord injury (SCI) patients with a cardiac pacemaker and the safety of bilateral ESWL performed on the same day. Design: A case report of bilateral ESWL in a SCI patient with a permanent cardiac pacemaker. Setting: The Regional Spinal Injuries Centre, Southport, the Lithotripsy Unit, the Royal Liverpool University Hospitals NHS Trust, Liverpool, and the Department of Cardiology, Manchester Royal In®rmary, Manchester, UK. Subject: A 43-year-old male sustained a T-4 fracture and developed paraplegia with a sensory level at T-2. During the post-injury period, he developed episodes of asystole requiring implantation of a dual chamber (DDD) permanent pacemaker. Twenty-one months later, he developed a right ureteric calculus with hydronephrosis. A radio-opaque shadow was seen in the left kidney with no hydronephrosis. During right ureteric stenting, the ureteric stone was pushed into the renal pelvis. 1,500 shock waves were delivered to this stone on the right side, followed by ESWL to the left intra-renal stone with 1250 shock waves. Results: The patient tolerated ESWL to both kidneys. The pacemaker was reprogrammed to a single chamber ventricular pacing mode at 30 beats per minute with a reduced sensitivity during lithotripsy. There were no untoward cardiac events during or after lithotripsy. The serum creatinine was 45 mmol/l before lithotripsy and 44 mmol/l two weeks after ESWL. Conclusion: SCI patients with a cardiac pacemaker may be able to undergo extracorporeal shock wave lithotripsy following temporary reprogramming of the pacemaker. Bilateral, simultaneous ESWL is safe in the vast majority of patients provided that there is no risk of simultaneous ureteric obstruction by stone fragments. However, it should be remembered that a decrease in renal function could occur following bilateral ESWL of renal calculi. Spinal Cord (2001) 39, 286 ± 289

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Acute pancreatitis caused by extracorporeal shock wave lithotripsy for bilateral renal pelvic calculi

Cited by 37 publications

References 4 publications

Standardized Grading of Shock Wave Lithotripsy Complications with Modified Clavien System

Standardized Grading of Shock Wave Lithotripsy Complications with Modified Clavien System

Acute necrotizing pancreatitis as a rare complication of extracorporeal shock wave lithotripsy

Bilateral extracorporeal shock wave lithotripsy in a spinal cord injury patient with a cardiac pacemaker

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