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Akbulut F et al, 2015: A Rare Complication of Extracorporeal Shock Wave Lithotripsy: Intrarenal Hematoma Mimicking Pelvis Renalis Tumor.

Akbulut F, Kucuktopcu O, Ucpinar B, Savun M, Ozgor F, Sonmezay E, Simsek A, Gurbuz G.
Department of Urology, Haseki Training and Research Hospital, 34096 Istanbul, Turkey.

Abstract

Extracorporeal shock wave lithotripsy (SWL) is a very commonly used treatment modality for appropriate sized stones. Even though it is a noninvasive treatment technique, major complications may occur following SWL sessions. Herein, we report a 17-year-old male patient, who received 2 sessions of SWL treatment for his left kidney stone, 4 months before his admission. Imaging methods showed an enhanced left renal pelvis mass with contrast-enhanced computerized tomography (CT) and this finding raised a suspicion of pelvis renalis tumor. Diagnostic ureterorenoscopy was planned for the patient and operation revealed a left intrarenal hematoma, which was drained percutaneously during the same operation. Careful history should be taken from patients with renal pelvis masses and intrarenal hematoma formation should be kept in mind, especially if the patient has a previous SWL history.

Case Rep Urol. 2015;2015:719618. doi: 10.1155/2015/719618. Epub 2015 May 12

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Comments 1

Hans-Göran Tiselius on Thursday, 27 August 2015 07:45

The authors describe a very unusual formation of hematoma in the renal pelvis as a consequence of SWL. This rapid development of renal pelvis tumour measuring 6 x 5 cm in a 17-year-old man 4 months after SWL is in itself unlikely, but nevertheless a dramatic finding. It would, however, have been interesting to know some further details of the initial SWL procedure and how the initial stone situation was. A more extensive evaluation with regard to coagulopathy might be rewarding [1]

Reference
1. Hughes SF, Thomas-Wright SJ, Banwell J, Williams R, Moyes AJ, Mushtaq S, Abdulmajed M, Shergill I.
A Pilot Study to Evaluate Haemostatic Function, following Shock Wave Lithotripsy (SWL) for the Treatment of Solitary Kidney Stones.
PLoS One. 2015 May 4;10(5):e0125840. doi: 10.1371/journal.pone.0125840. eCollection 2015

The authors describe a very unusual formation of hematoma in the renal pelvis as a consequence of SWL. This rapid development of renal pelvis tumour measuring 6 x 5 cm in a 17-year-old man 4 months after SWL is in itself unlikely, but nevertheless a dramatic finding. It would, however, have been interesting to know some further details of the initial SWL procedure and how the initial stone situation was. A more extensive evaluation with regard to coagulopathy might be rewarding [1] Reference 1. Hughes SF, Thomas-Wright SJ, Banwell J, Williams R, Moyes AJ, Mushtaq S, Abdulmajed M, Shergill I. A Pilot Study to Evaluate Haemostatic Function, following Shock Wave Lithotripsy (SWL) for the Treatment of Solitary Kidney Stones. PLoS One. 2015 May 4;10(5):e0125840. doi: 10.1371/journal.pone.0125840. eCollection 2015
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