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Perinephric inflammatory process following extracorporeal shock wave lithotripsy
International Urology and Nephrology
|January 1, 1991
Summary
Extracorporeal shock wave lithotripsy (ESWL) for staghorn calculi can lead to serious complications like perinephric abscesses, especially in patients with recurrent urinary tract infections. Prompt drainage is crucial for managing this adverse event.
Area of Science:
- Nephrology
- Urology
- Infectious Diseases
Background:
- Staghorn calculi present a complex treatment challenge in urology.
- Recurrent urinary tract infections (UTIs) are a known risk factor for complications in stone management.
- Extracorporeal shock wave lithotripsy (ESWL) is a common modality for treating renal calculi.
Observation:
- A patient with large, branched staghorn calculi and a history of recurrent UTIs underwent ESWL.
- Post-ESWL, the patient developed a perinephric abscess, a rare but severe complication.
- Percutaneous drainage was required to manage the abscess.
Findings:
- ESWL in patients with staghorn calculi and recurrent UTIs carries a risk of perinephric abscess formation.
- The clinical course highlights the potential for serious infectious complications following ESWL.
- A suggested pathogenesis links ESWL-induced tissue injury and pre-existing infection to abscess development.
Implications:
- Clinicians should consider the risk of perinephric abscess in patients undergoing ESWL for complex calculi, particularly those with UTIs.
- Enhanced monitoring and prompt intervention are necessary for patients developing post-ESWL complications.
- Further research into the pathogenesis may inform preventative strategies for ESWL-related infections.