Hepatic subcapsular hematoma breaking into the abdominal cavity after extracorporeal shock wave lithotripsy for pancreatic stones

Bi, Ya Wei; Wang, Dan; Du, Ting Ting; Liao, Zhuan; Li, Zhao Shen; Hu, Liang

doi:10.1111/1751-2980.12510

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…The overall complication rate was 6.7%, including pancreatitis, bleeding, infection, steinstrasse, and perforation. [ 6 ] Rare complications have also been reported, such as hepatic subcapsular hematoma, [ 3 ] splenic hematoma, [ 7 ] colonic hematoma, [ 8 ] large mesenteric hematoma, [ 9 ] and pancreaticobiliary fistula. [ 10 ] Lung contusion has been reported after urinary ESWL, [ 11 ] but to our knowledge, lung contusion has never been reported after P-ESWL.…”

Section: Discussionmentioning

confidence: 99%

“…The shock wave head contacted with right upper quadrant and the path of shock wave was at a 45° angle to the ventral midline. [ 3 ] Up to 5000 shock waves were delivered per therapeutic session at an intensity of 6 (16,000 kV) on a scale of 1 to 6 with a frequency of 120 shocks/min. During the procedure, flurbiprofen and remifentanil were combined for analgesia by intravenous infusion.…”

Section: Case Presentationmentioning

confidence: 99%

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Lung contusion after extracorporeal shock wave lithotripsy for pancreatic stones: A case report

Wang

Chen

et al. 2022

Medicine

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Background: Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is recommended as the first-line treatment for large pancreatic stones. While complications such as post-P-ESWL pancreatitis, bleeding, infection, steinstrasse, and perforation have been reported in the past 30 years, lung contusion has never been reported. The present case demonstrates lung contusion as a complication after P-ESWL. Methods: A 48-year-old man was admitted to our department due to painful chronic pancreatitis with pancreatic duct stones. Computed tomography revealed normal lungs. P-ESWL was performed. The shock wave head contacted with right upper quadrant and the path of shock wave was at a 45° angle to the ventral midline. After P-ESWL, multiple patchy high-density shadows in the lower lobe of right lung were found, which was normal before P-ESWL. The patient had no symptoms of lung injury. Results and Conclusion: Laboratory studies revealed elevated D-dimer from 0.33 to 0.74 ug/mL, which was consistent with abnormal clotting of lung contusion. Chest computed tomography showed slight pleural effusion. Considering the interval between 2 X-rays was only 3 hours, we inferred that lung contusion was related to P-ESWL. The patient displayed stable vital signs, therefore, no specific interventions were conducted. Three days after P-ESWL, endoscopic retrograde cholangiopancreatography was performed and the lung shadows were partially absorbed. Considering the location of shock wave head, it was possible to cause lung contusion in lower lobe of right lung. More than 10,000 P-ESWL therapeutic sessions had been performed in our center since 2010, and it is the first case about lung contusion as a complication. It is also the first report to describe lung contusion after P-ESWL. Although the patient was asymptomatic, it should raise awareness of clinicians.

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Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

Lung contusion after extracorporeal shock wave lithotripsy for pancreatic stones: A case report

Wang

Chen

et al. 2022

Medicine

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“…Among the complications, bleeding occurring in bounded organ is rarely reported with the reported incidence rate of 0.3% [4]. The previously reported hematoma includes: hepatic subcapsular hematoma [6], hilar hematoma [7] and splenic hematoma [8]. To date, colonic hematoma has not been reported before.…”

Section: Discussionmentioning

confidence: 99%

Colonic hematoma after extracorporeal shock wave lithotripsy for pancreatic stones: a case report

et al. 2019

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BackgroundDespite pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is a minimally invasive treatment for pancreatic stones, complications exist.Case presentationA 37-year-old male was diagnosed with chronic pancreatitis and admitted to our hospital for recurrent acute pancreatitis. After the first P-ESWL session, the patient complained of a new type of pain different from the previous pain pattern. Computerized tomography and colonoscopy were arranged and colonic hematoma was found. Since the patient had stable vital signs, no special treatment was given focusing on the colonic hematoma. Five days later, P-ESWL treatment was repeatedly performed for four consecutive days. Two days after the last P-ESWL session, the patient underwent endoscopic retrograde cholangiopancreatography. At the three-month follow up visit, the colonic hematoma disappeared and pancreatic stones decreased significantly.ConclusionsTo the best of our knowledge, colonic hematoma after P-ESWL for pancreatic stones has never been reported. Here, we present the only case of colonic hematoma after P-ESWL, which was coincidentally found in more than 6000 P-ESWL sessions in our hospital. As the symptoms of colonic hematoma are mild, we believe the incidence of colonic hematoma has been underestimated. Many people with colonic hematoma after P-ESWL may be undiagnosed or misdiagnosed. Treatment for colonic hematoma depends on whether there is severe clinical state. Exploration of more precise location method for pancreatic stones may reduce the probability of P-ESWL complication.

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“…[ 18 ] Bleeding which usually occurs in bounded organ is a rare complication with a low incidence rate of 0.3%. [ 18 ] The location of hematoma that has been reported includes: hepatic subcapsular hematoma [ 19 ] and hilar hematoma. [ 20 ] Mesenteric hematoma is a very rare complication after P-ESWL which has never been reported before.…”

Section: Discussionmentioning

confidence: 99%

Large mesenteric hematoma after extracorporeal shock wave lithotripsy for pancreatic stones

et al. 2018

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Rationale:Mesenteric hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones is a very rare complication which has never been reported before.Presenting concerns:We reported a case of a 36-year-old male diagnosed as chronic pancreatitis with pancreatic stones and a large pancreatic pseudocyst. He underwent 3 repeated sessions of pancreatic ESWL (P-ESWL). After the last session of P-ESWL, he complained of dizziness. Physical examination revealed a large mass in the right abdomen.Diagnosis:Emergent upper abdominal computerized tomography (CT) revealed this mass is a mesenteric hematoma with the size of 8.2 cm × 11.7 cm in the right abdominal cavity after P-ESWL and there was no sign of intestinal obstruction.Interventions:With close monitoring of vital signs, the patient received conservative treatment for several days. Dynamic abdominal ultrasound monitoring revealed the mesenteric hematoma had organized.Outcomes:Vital signs of the patient were stable after fluid transfusion. Three-month follow-up CT showed the mesenteric hematoma had absorbed completely.Lessons:Mesenteric hematoma rarely occurs after P-ESWL and it alerts us the importance of considering uncommon complications after P-ESWL. If mesenteric hematoma occurs after P-ESWL, conservative treatment could be the first choice while surgery can also be considered.

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Hepatic subcapsular hematoma breaking into the abdominal cavity after extracorporeal shock wave lithotripsy for pancreatic stones

Cited by 7 publications

References 11 publications

Lung contusion after extracorporeal shock wave lithotripsy for pancreatic stones: A case report

Lung contusion after extracorporeal shock wave lithotripsy for pancreatic stones: A case report

Colonic hematoma after extracorporeal shock wave lithotripsy for pancreatic stones: a case report

Large mesenteric hematoma after extracorporeal shock wave lithotripsy for pancreatic stones

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