SWL literature
Slider

Zodda D et al, 2017: A Novel Case of Splenic Injury After Shockwave Lithotripsy.

Zodda D, Haley M, Sayegh R.
Hackensack University Medical Center, Hackensack, New Jersey.

Abstract

BACKGROUND: Emergency departments (EDs) are gateways for patients presenting after minor surgical procedures, particularly shockwave lithotripsy. Complications include renal and extrarenal tissue injuries, with the latter having potentially serious consequences if not detected early.
CASE REPORT: We describe a 70-year-old male presenting to the ED for syncope. The patient underwent shockwave lithotripsy (SWL) for left kidney stones 1 day prior. Upon initial evaluation, the patient had normal vital signs and a normal physical examination, without complaints of abdominal pain. Close observation and regular patient re-evaluation led to the diagnosis of life-threatening injuries that included splenic rupture. Although this is a rare complication of SWL, with only eight published cases found in the literature, the patient's initial presentation of syncope without complaints of abdominal pain presented a unique diagnostic challenge.
WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be knowledgeable of the pre-existing conditions linked to higher rates of complications after shockwave lithotripsy and be able to identify and manage these potentially life-threatening complications.

J Emerg Med. 2017 Apr 10. pii: S0736-4679(17)30142-7. doi: 10.1016/j.jemermed.2017.02.007. [Epub ahead of print]

 

0
 

Commenti 1

Hans-Göran Tiselius il Venerdì, 13 Ottobre 2017 10:05

Splenic rupture is an extremely unusual complication of SWL. The lesson learnt over the years is that any patient that presents with unusual symptoms shortly after SWL needs appropriate attention. Exclusion of cardiovascular complications as well as CT-examination is mandatory.

Why the patient in this “case report” suffered extensive bleeding from the spleen is not mentioned, but it is important to make sure that patients treated with SWL are without anticoagulation treatment such as aspirin or other agents of similar kind.

Splenic rupture is an extremely unusual complication of SWL. The lesson learnt over the years is that any patient that presents with unusual symptoms shortly after SWL needs appropriate attention. Exclusion of cardiovascular complications as well as CT-examination is mandatory. Why the patient in this “case report” suffered extensive bleeding from the spleen is not mentioned, but it is important to make sure that patients treated with SWL are without anticoagulation treatment such as aspirin or other agents of similar kind.
Ospite
Giovedì, 18 Luglio 2019
STORZ MEDICAL AG
Lohstampfestrasse 8
8274 Tägerwilen
Switzerland
Tel.: +41 (0)71 677 45 45
Fax: +41 (0)71 677 45 05

www.storzmedical.com