Budzyn J. et al., 2021: Life threatening hepatic hemorrhage after shockwave lithotripsy - A case report and review of literature.
Budzyn J, Leavitt D.
Henry Ford Health System, Department of Urology, 2799 W Grand Blvd, Detroit, MI, 48202, USA.
We report a 31 year old female with urologic history significant for right ureteropelvic junction obstruction managed with open right pyeloplasty in 1996 with recurrent stricture managed with right ureterocalycostomy in 1997 along with right distal ureteroneocystostomy for iatrogenic distal ureteral stricture. She developed symptomatic stone episodes and recurrent urinary tract infections and elected to proceed with shockwave lithotripsy. Postoperatively she developed a large liver hemorrhage requiring supportive care and endovascular embolization.
Urol Case Rep. 2021 May 24;38:101724. doi: 10.1016/j.eucr.2021.101724. eCollection 2021 Sep. PMID: 34136358. FREE ARTICLE
Severe complications such as subcapsular renal and liver hematomas are rare, but bleeding complications of this kins always should be suspected when patients return to the emergency unit with unexpected pain shortly after SWL. The lesson learnt is that generous imaging with NCCT should be carried out as early as possible and signs of blood loss (Hb-decrease) . alerted.