Alzeerelhouseini HIA. et al., 2021: Acute pancreatitis with giant pancreatic pseudocyst as a complication of extracorporeal shock wave lithotripsy: A case report and literature review.
Alzeerelhouseini HIA, Abuzneid YS, Ashhab HA.
Al-Quds University, Faculty of Medicine, Jerusalem, Palestine.
Al-Ahli Hospital, Hebron, Palestine.
Introduction: Extracorporeal shock wave lithotripsy has been confirmed as the least invasive and the most widely used treatment for kidney and ureteral stones. However, as with any other type of therapy, potential complications do exist.
Case presentation: Herein, we describe a 55-year-old male patient who developed symptoms of acute pancreatitis one day after extracorporeal shock wave lithotripsy for left renal stones. The patient used to manage himself with NSAIDs till he presented to the emergency department with severe epigastric pain and tenderness due to giant pancreatic pseudocyst formation. The pseudocyst was treated by endoscopic cystogastrostomy using metallic stent with uneventful recovery. In addition, we extensively reviewed all available literature studies of pancreatitis and pancreatic pseudocyst occurring after extracorporeal shock wave lithotripsy. We summarized all reported cases and presented them in a comprehensive table.
Discussion: Post ESWL acute pancreatitis is a rare clinical entity with only 11 reported cases. In all cases, abdominal pain was the most common symptom that occurs in less than 24h following ESWL treatment. So it should be considered in the differential diagnosis of acute abdominal pain after ESWL.
Conclusion: Although ESWL is generally considered safe and effective treatment; however, major complications have been reported to occur in less than 1% of patients. One of the extremely rare complications is the development of pancreatitis and pancreatic pseudocyst.
Ann Med Surg (Lond). 2021 May 26;66:102442. doi: 10.1016/j.amsu.2021.102442. eCollection 2021 Jun. PMID: 34136213. FREE ARTICLE
A rare complication of ESWL of kidney stones especially considering the frequent routine ESWL treatment of pancreatic duct stones. The paper was prepared according to the guidelines for preparing manuscripts of case reports (1). I admit, I did not know about them.
1 Agha RA, Franchi T, Sohrabi C, Mathew G, Kerwan A; SCARE Group. The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines. Int J Surg. 2020 Dec;84:226-230. doi: 10.1016/j.ijsu.2020.10.034. Epub 2020 Nov 9. PMID: 33181358.