Kodama K et al, 2018: Renal arteriovenous fistula induced by extracorporeal shock wave lithotripsy treated by retroperitoneoscopic nephrectomy.
Kodama K, Takase Y, Tokai R, Saito K.
Department of Urology, Toyama City Hospital, Toyama, Japan.
Department of Pathology, Toyama City Hospital, Toyama, Japan.
Renal arteriovenous fistula (AVF) is a rare but potentially severe and life-threatening entity. It can occur after various invasive renal interventions, including resection of a localized renal tumor, renal biopsy, percutaneous renal surgery, and even blunt injury of the kidney. The time of clinical presentation of a renal AVF is variable and may occur decades after the injury originally occurred. Here, we report a case of renal AVF induced by extracorporeal shock wave lithotripsy 11 years earlier in an asymptomatic 72-year-old woman. Given the patient's pre-existing hemodialysis dependence, retroperitoneoscopic nephrectomy was performed. On the basis of patient's clinical history, the location of the renal AVF, and the pathological diagnosis, we suggested that renal AVF was a late consequence of the injury to the intrarenal vessels induced by extracorporeal shock wave lithotripsy.
Asian J Endosc Surg. 2018 Sep 21. doi: 10.1111/ases.12651. [Epub ahead of print]
Case report of an arterio-venous fistula that was assumed to be the consequence of SWL directed towards the lower calyx. It is amazing that SWL had been carried out 11 years (!!) before diagnosis of the arterio-venous fistula. I am not aware of this complication in any of the patients that I have treated with SWL, but surprisingly long observation periods seem necessary.