Department of Gastroenterology, Gongli Hospital.Changhai Hospital, The Second Military Medical University, Shanghai.
Hainan Branch of Chinese PLA General Hospital, Sanya.
Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai.
Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Guangdong, China

Abstract

RATIONALE: Mesenteric hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones is a very rare complication which has never been reported before. PRESENTING CONCERNS: We reported a case of a 36-year-old male diagnosed as chronic pancreatitis with pancreatic stones and a large pancreatic pseudocyst. He underwent 3 repeated sessions of pancreatic ESWL (P-ESWL). After the last session of P-ESWL, he complained of dizziness. Physical examination revealed a large mass in the right abdomen. DIAGNOSIS: Emergent upper abdominal computerized tomography (CT) revealed this mass is a mesenteric hematoma with the size of 8.2 cm × 11.7 cm in the right abdominal cavity after P-ESWL and there was no sign of intestinal obstruction. INTERVENTIONS: With close monitoring of vital signs, the patient received conservative treatment for several days. Dynamic abdominal ultrasound monitoring revealed the mesenteric hematoma had organized. OUTCOMES: Vital signs of the patient were stable after fluid transfusion. Three-month follow-up CT showed the mesenteric hematoma had absorbed completely. LESSONS: Mesenteric hematoma rarely occurs after P-ESWL and it alerts us the importance of considering uncommon complications after P-ESWL. If mesenteric hematoma occurs after P-ESWL, conservative treatment could be the first choice while surgery can also be considered.

Medicine (Baltimore). 2018 Nov;97(44):e13114. doi: 10.1097/MD.0000000000013114. FREE ARTICLE