An absence of changes in kidney tissues after an enormous number of shock waves

Repeated sessions of unilateral extracorporeal shock wave lithotripsy (ESWL) were performed in a patient with multiple bilateral calycolithiasis who suffered from Crohn's disease of long duration and from recurrent gastric ulcers. To achieve complete clearance of stones from the left kidney it was necessary to apply 10,000 shock waves during seven sessions within five weeks. This number is exceedingly high compared to average total doses which were applied to other patients of our group (920 SW per one session). For the treatment was used an electrohydraulic lithotripter (Medipo). A surgical reconstruction of the abdominal wall which had been planned long before was made six weeks after the last ESWL session. The postoperative course was complicated by bleeding gastric ulcer of which the patient died despite an intensive treatment. The autopsy and histology revealed no damage of kidney tissue or adjacent organs caused by ESWL.