Splenic Abscess after Lithotripsy of Pancreatic Duct Stones

Plaisier, P. W.; Hoed, P.T. den

doi:10.1159/000050140

Cited by 16 publications

(3 citation statements)

References 12 publications

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“…Minor reported complications of pancreatic ESWL are exacerbation of pancreatitis, mild abdominal discomfort and asymptomatic hyperamylasemia. Serious complications reported included hepatic sub‐capsular hematoma, 14 splenic rupture with life‐threatening hemorrhage, 15 splenic abscess formation, 16 gastric sub‐mucosal hematoma, cholangitis, pancreatitis‐related sepsis and fluid collections 8 . Complication rates reported range from 0 to 20% of cases.…”

Section: Introductionmentioning

confidence: 99%

Multiple main pancreatic duct stones in tropical pancreatitis: Safe clearance with extracorporeal shockwave lithotripsy

Ong

Tandan

Reddy

et al. 2006

J of Gastro and Hepatol

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Background and Aim: Extracorporeal shockwave lithotripsy (ESWL) has an established role in the management of pancreatic ductal stones. Its efficacy in management of multiple stones in tropical pancreatitis is unknown. The aim of this study was to prospectively evaluate: (i) the efficacy of main pancreatic duct stone clearance; and (ii) associated complications with ESWL therapy in tropical pancreatitis. Methods: Consecutively recruited patients with tropical pancreatitis underwent fragmentation of main pancreatic duct stones using ESWL. Endoscopic retrograde cholangiopancreatography (ERCP) using standard techniques was performed to manage residual stones. Complete, partial and unsatisfactory clearance was defined as > 90%, 50-90% and < 50% of stone clearance, respectively. Clinical and technical data were collected on a pre-formatted data sheet. Statistical analysis was performed on an intention-to-treat basis. Results: A total of 250 patients (mean ± SD age 35.2 ± 11.9 years; 66% men), 86.8% with multiple radio-opaque stones, underwent ESWL between February 2004 and May 2005. Of the 250 patients, 149 (59.6%) achieved complete clearance and 59 (23.6%) achieved partial clearance of pancreatic calculi. Main pancreatic ductal decompression was achieved in 70.0% (175/250) of patients. Complications occurred in 5.6% (14/250) during ESWL and in 1.2% (3/250) during ERCP. A mean of 1.3 sessions, with mean ± SD 5.5 ± 0.7 intensity setting, 85.8 ± 13.5 pulses per minute and 3862 ± 1426 shocks per session were required. Conclusion: Clearance of multiple main pancreatic duct stones in patients with tropical pancreatitis is safely performed via ESWL followed by ERCP ductal drainage.

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Section: Introductionmentioning

confidence: 99%

Multiple main pancreatic duct stones in tropical pancreatitis: Safe clearance with extracorporeal shockwave lithotripsy

Ong

Tandan

Reddy

et al. 2006

J of Gastro and Hepatol

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“…For these patients, broad-spectrum antibiotic therapy at an early stage is recommended, and effective antibiotics should be selected based on the blood culture result or antibacterial susceptibility test. In addition, there are still a small number of patients with delayed splenic abscess, severe cases can develop into sepsis or peritonitis, for which splenectomy has to be performed, abscess drainage or puncture catheter can also become a treatment choice according to the change of illness condition [ 23 ]. Common bile duct stricture can occur as a consequence of pancreatic parenchymal oedema after P-ESWL, which may be associated with a high risk of developing cholangitis or sepsis.…”

Section: Manifestations and Management Of Complicationsmentioning

confidence: 99%

Adverse events of pancreatic extracorporeal shock wave lithotripsy: a literature review

Yi,

Li,

2023

BMC Gastroenterol

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Pancreatic stones are the result of pathophysiologic changes in chronic pancreatitis with an incidence of more than 90%. At present, pancreatic extracorporeal shock wave lithotripsy (P-ESWL) can be used as the first-line treatment for large or complex stones. Although a large number of studies have proven the safety and effectiveness of P-ESWL, we should also pay attention to postoperative adverse events, mainly due to the scattering of shock waves in the conduction pathway. Adverse events can be classified as either complications or transient adverse events according to the severity. Because the anatomic location of organs along the shock wave conducting pathway differs greatly, adverse events after P-ESWL are varied and difficult to predict. This paper outlines the mechanism, definition, classification, management and risk factors for adverse events related to P-ESWL. It also discusses the technique of P-ESWL, indications and contraindications of P-ESWL, and adverse events in special populations.

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“…In our experience of 58 patients with ESWL, only transient abdominal pain occurred in one‐quarter of patients. Some investigators have reported bleeding,,, splenic rupture, splenic abscess, and sepsis, after ESWL.…”

Section: Outcomes Of Eswlmentioning

confidence: 99%

Extracorporeal shock wave lithotripsy for the treatment of pancreatic duct stones

Choi

Kim

2006

J Hepatobiliary Pancreat Surg

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The purpose of endoscopic therapy in chronic pancreatitis is to decompress the main pancreatic duct and to remove the obstacles that impede the ductal flow of pancreatic juice. The availability of extracorporeal shock wave lithotripsy (ESWL) has improved the results of endoscopic drainage of the main pancreatic duct and has also expanded the indications of endoscopic therapy for chronic pancreatitis. This article briefly reviews ESWL for pancreatic duct stones in patients with chronic pancreatitis, including our experience with ESWL. ESWL is an effective and safe procedure for endoscopically unremovable main pancreatic duct stones, and, in selected patients, ESWL alone may be effective.

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Splenic Abscess after Lithotripsy of Pancreatic Duct Stones

Abstract: We describe a case of splenic abscess following lithotripsy of pancreatic stones, for which emergency splenectomy eventually had to be performed. It is important to be aware of this complication, because splenic abscess is still a life-threatening entity.

Cited by 16 publications

References 12 publications

Multiple main pancreatic duct stones in tropical pancreatitis: Safe clearance with extracorporeal shockwave lithotripsy

Multiple main pancreatic duct stones in tropical pancreatitis: Safe clearance with extracorporeal shockwave lithotripsy

Adverse events of pancreatic extracorporeal shock wave lithotripsy: a literature review

Extracorporeal shock wave lithotripsy for the treatment of pancreatic duct stones

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