Small bowel perforation after extracorporeal shock wave lithotripsy

Geh, Jenny; Curley, P.; Mayfield, M.P.; Price, Jeremy

doi:10.1046/j.1464-410x.1997.00162.x

Cited by 30 publications

(10 citation statements)

References 1 publication

(1 reference statement)

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“…10 The major complications, including kidney rupture, psoas abscess formation, subcapsular hematoma of the spleen, acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, aortic aneurysm rupture, and intracranial hemorrhage, have been reported to occur in less than 1% of patients. [6][7][8]14,16 The mechanism of hematoma formation is related to the piercing effect of a liquid microjet, which has an impact velocity of more than 200 m/second and occurs as the tiny bubbles and the shock wave interact. 10 Inertial cavitation is an important mechanism of ultrasoundinduced nonthermal bioeffects.…”

Section: Discussionmentioning

confidence: 99%

Thoracic spinal cord epidural hematoma after extracorporeal shock wave lithotripsy

Lee¹,

Lee²,

Yoo³

et al. 2012

SPI

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Extracorporeal shock wave lithotripsy (ESWL) is a well-established, safe, and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. Formation of a spinal epidural hematoma is an extremely rare complication after ESWL for kidney stone removal. The authors present the case of a 61-year-old man in whom a large spinal epidural hematoma developed after ESWL. They discuss the possible pathogenic mechanism of such a complication.

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Section: Discussionmentioning

confidence: 99%

Thoracic spinal cord epidural hematoma after extracorporeal shock wave lithotripsy

Lee¹,

Lee²,

Yoo³

et al. 2012

SPI

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“…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%

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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“…Unsere Literaturrecherche brachte lediglich zwei sicher dokumentierte vergleichbare Fälle zu Tage [4,5]. In beiden Fällen hatten mehrere ESWL-Sitzungen stattgefunden, und die letzte Stoûwellenapplikation war bei offensichtlich vergleichbarer Impulszahl (einmal 4500 SW, einmal keine Angabe) ebenso wie bei unserem Patienten von vorne erfolgt.…”

Section: Diskussionunclassified

Dünndarmperforation nach Nephro-Uretero-Lithotripsie durch ESWL – eine seltene Komplikation

Kurtz¹,

Müller-Sorg²,

Federmann³

1999

Chirurg

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A man of 57 suffering from nephroureterolithiasis was treated by ESWL (6 sessions) both in the prone and supine positions. Several hours after the last treatment (prone position) the patient complained about increasing abdominal pain which we found to be caused by an intra-abdominal perforation. In an emergency laparotomy we detected a perforation on the ventral wall of a small bowel loop, which was fixed at the colon ascendens on the rear side. Histological examination provided no evidence of previously existing intestinal disease. Thus, we suggest that this case is a rare major complication of ESWL.

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Small bowel perforation after extracorporeal shock wave lithotripsy

Cited by 30 publications

References 1 publication

Thoracic spinal cord epidural hematoma after extracorporeal shock wave lithotripsy

Thoracic spinal cord epidural hematoma after extracorporeal shock wave lithotripsy

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

Dünndarmperforation nach Nephro-Uretero-Lithotripsie durch ESWL – eine seltene Komplikation

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