Frost F et al, 2018: Between a Rock and an Airspace: Pneumothorax After Extracorporeal Shock Wave Lithotripsy for Renal Stones in a Patient With Cystic Fibrosis.
Frost F, Griffiths P, Brockelsby C, Lynch C, Walshaw MJ, Nazareth D.
Adult CF Centre, Liverpool Heart and Chest Hospital, Liverpool, UK.
Urology Department, Royal Liverpool and Broadgreen University Hospital, Liverpool, UK.
Abstract
Renal disease is a well-recognized manifestation of cystic fibrosis (CF) and people with CF are at increased risk of nephrolithiasis. Lithotripsy is the preferred treatment but has occasionally been associated with pulmonary complications. Here we report the case of a person with CF who developed a pneumothorax soon after lithotripsy and discuss the potential mechanism of injury. We hope this case highlights some of the additional considerations clinicians should take into account when managing patients with advanced pulmonary disease in CF.
Chest. 2018 Sep;154(3):e61-e63. doi: 10.1016/j.chest.2018.03.023
Comments 1
The authors describe a case of pneumothorax following SWL. This patient suffered from CS (cystic fibrosis) and was most certainly particularly vulnerable to pulmonary lesions.
It is correctly stated in the article that this was the first case of pneumothorax as a consequence of SWL reported in the literature.
Although early warnings were made for this kind of complication following SWL, the risk of pneumothorax appears to be extremely low. Some cases might of course have occurred without being published, others perhaps without being noticed, but in my own experience of around 25 000 SWL-treatments I have never encountered this complication.