Wang X. et al., 2020: Abdominal aortic rupture after extracorporeal shockwave lithotripsy: A rare case report and literature review
Wang X, Zhang B, Zhu Y, Ge H.
Department of Vascular Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Extracorporeal shockwave lithotripsy (ESWL) is a common and effective treatment method for most renal and upper ureteral calculi. Aortic rupture after ESWL is an extremely rare complication. Seven cases of aortic rupture have been reported to date, and only one case involved the rupture of a calcified abdominal aorta. We herein describe a Chinese patient who was hospitalized for rupture of the abdominal aorta 5 days after ESWL for right ureteral calculi. The patient was transferred to the Department of Vascular Surgery and underwent emergency endovascular aortic repair. The patient's recovery was unremarkable. One week after the operation, enhanced computed tomography showed that the size of the hematoma around the periaortic area was constant, and repeat enhanced computed tomography 1 month later showed that the hematoma had been significantly absorbed. ESWL may cause rupture of a heavily calcified abdominal aorta. We suggest that all patients with atherosclerosis being considered for ESWL should be evaluated by imaging examinations both preoperatively and during follow-up.
J Int Med Res. 2020 Jun;48(6):300060520931608. doi: 10.1177/0300060520931608. PMID: 32538691. FREE ARTICLE
Knowing the exact position of the stone and the direction of the shock wave path could further clarify if shock waves really caused the rupture or if it was incidental.