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Gupta S et al, 2016: Abdominal Compartment Syndrome and Necrotizing Pancreatitis Following Extracorporeal Shock Wave Lithotripsy.

Gupta S, Scambia J, Gandillon C, Aversano F, Batista R.
Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA.

Abstract

Extracorporeal shock wave lithotripsy (ESWL) is a common procedure in the treatment of renal calculi. There have been major complications reported with ESWL such as acute pancreatitis, bowel perforation, venous thrombosis, and biliary obstruction. There are few reports in the literature of necrotizing pancreatitis secondary to ESWL. We have a case report of a 29-year-old female that developed an abdominal compartment syndrome with an acute necrotizing pancreatitis hours after extracorporeal shock wave lithotripsy. 

Urol Case Rep. 2016 Jul 13;8:34-5. doi: 10.1016/j.eucr.2016.05.006. eCollection 2016 Sep.

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Comments 1

Hans-Göran Tiselius on Monday, 30 January 2017 11:44

This article describes an extremely unusual complication of SWL: necrotizing pancreatitis and abdominal compartment syndrome. This complication was associated with multiple organ failure; a life-threatening condition.

There is no explanation provided in the report why this young woman (29 years old) was afflicted by this very serious complication. Little is mentioned about the SWL procedure and if this was successful or not. Were the shockwaves directed from the back or transabdominally? Was it easy to focus the stone and how extensive was the treatment? These questions are important because it is difficult to judge from the CT-images in the article how close to the pancreas that the UPJ-stone was located. It appears as if the assumed stone position and the right renal pelvis are at different levels, but conclusions in that regard can only be drawn from careful examination of the images and details of the SWL procedure.
If a direct traumatic effect of shock waves can be excluded other possible explanatory factors need to be considered.

This article describes an extremely unusual complication of SWL: necrotizing pancreatitis and abdominal compartment syndrome. This complication was associated with multiple organ failure; a life-threatening condition. There is no explanation provided in the report why this young woman (29 years old) was afflicted by this very serious complication. Little is mentioned about the SWL procedure and if this was successful or not. Were the shockwaves directed from the back or transabdominally? Was it easy to focus the stone and how extensive was the treatment? These questions are important because it is difficult to judge from the CT-images in the article how close to the pancreas that the UPJ-stone was located. It appears as if the assumed stone position and the right renal pelvis are at different levels, but conclusions in that regard can only be drawn from careful examination of the images and details of the SWL procedure. If a direct traumatic effect of shock waves can be excluded other possible explanatory factors need to be considered.
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