Ruptured kidney as complication of extracorporeal shock wave lithotripsy
Authors:
Tomáš Ürge 1; Jiří Kouba 1; Jan Jambura 1; Milan Hora 1; Václav Havel 2; Tomáš Skalický 3
Authors‘ workplace:
Urologická klinika LF UK a FN Plzeň
1; Radiodiagnostické oddělení LF UK a FN Plzeň
2; Chirurgická klinika LF UK a FN Plzeň
3
Published in:
Ces Urol 2009; 13(3): 217-222
Category:
Case report
Overview
Objective:
Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive method for renal stone treatment. Major complications are: rupture of kidney, spleen and cauda of pancreas. We present two cases of these complications, which demanding urgent surgery.
Case 1:
Woman, 58 year old, with 6 mm lithiasis in pelviureteral junction of right kidney was carried out the endoscopic relocation of stone, emposed double loop ureteral stent and ESWL with desintegration of lithiasis. The complication was retroperitoneal haematoma. We performed suture of dorsal renal lip and evacuated haematoma. Woman was released 7 days after surgery and ureteral stent was removed 4 weeks later. We did not prove residual lithiasis; we suppose its spontaneous leaving.
Case 2:
Man, 36 years old, with Crohn disease using cyclic parenteral nutrition for syndrome of short limited intestine. The complications were steatosis of liver, cholecystolithiasis and bilateral nephrolithiasis. ESWL with its desintegration on the right side was carried out without complications in March 2008. ESWL with partial desintegration on the left side was performed in September 2008. The complication was renal subcapsular haematoma. We conducted surgery for progression 2 days later, suture of ruptured kidney, pancreas and spleen. The next complication was malnutrition and formation of perirenal and intraabdominal infectious haematoma. Surgery with splenectomy and empossing double loop ureteral stent was necessary.
Conclusion:
We can present these cases for severe complications after therapy which is known as noninvasive and safe. The cases confirm necessity of monitoring patients after ESWL.
Key words:
extracorporeal lithotripsy, retroperitonea haematoma, rupture of kidney.
Sources
1. Streem S. Contemporary clinical practice of shock wave lithotripsy: A reevaluation of contraindications. J Urol 1997; 157: 1197–1203.
2. Tailly GG. Management of acute post ESWL complications. Ces Urol 2000; 2: 5–8.
3. Marberger M, Turk C, Steinkogler I. Painless Piezoelectric Extracorporeal Lithotripsy. J Urol 1988; 139: 695–699.
4. Tiselius H-G. Guidelines on urolitiasis. European Association of Urology 2002.
5. Lingeman JE, Siegel YI, Steele B, et al. Management of lower pole nephrolithiasis: A critical analysis. J Urol 1994; 151: 663–667.
6. Vidlák A. Diagnostika a léčka urolitiázy. Med Pro Praxi 2007; 4: 528–530.
7. Vienweg J, Weber HM, Miller K, et al. Female fertility following extracorporeal shock wave lithotripsy of distal ureter calculi. J Urol 1992; 148: 1007.
8. Petřík A. Porovnání účinností extrakorporální litotrypse a ureteroskopie při primární terapii ureterolitiázy dolní třetiny ureteru. Čas Lék čes 2007; 146: 776–780.
9. Moran ME, Sandock D, Drach GW. Effects of high energy shock waves on chick embryo development. J Urol 1990; 143: 230 A.
10. Mendoza E, Beer M, Weber C, et al. ESWL during pregnancy? Endourol 1991; 5(Suppl 1): 48.
11. Dhar NB, Thornton J, Karafa MT, et al. A multivariate analysis of risk factors
associated with subcapsular hematoma formation following electromagnetic shock wave lithotripsy. J Urol 2004; 172: 2271–2274.
12. Marcuzzi D, Gray R, Wesley-James T. Symptomatic splenic rupture following extracorporeal shock wave lithotripsy. J Urol 1991; 145: 547–548.
13. Evan AP, McAteer JA, Connors BA, Blomgren PM, Lingeman JE. Renal injury during shock wave lithotripsy is significantly reduced by slowing the rate of shock wave delivery. BJU Int 2007; 100: 624–627.
14. Bahceci M, Tuzcu A, Akay F, et al. Serious clopidogrelassociated renal hematoma in a type 2 diabetic patient with primary hyperparathyroidism after extracorporeal shock wave lithotripsy. Saudi Med J 2005; 26: 1007–10094.
15. Sare GM, Lloyd FR, Stower MJ. Life-threatening haemorrhage after extracorporeal shock wave lithotripsy in a patient taking clopidogrel. BJU Int 2002; 90: 469.
16. Poršová M, Kaplan O, Pabišta R, et al. Ruptura sleziny, vzácná komplikace po LERV. Urologie pro praxi 2005; 5: 213–215.
Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2009 Issue 3
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