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Updated: Feb 28, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
[Colonic perforation after extracorporeal shock wave lithotripsy]
1Urologische Klinik am Diakoniekrankenhaus Mannheim. W.Kurz@diako-ma.de
History And Clinical Findings:
A 40-year-old man had undergone extracorporeal shock wave lithotripsy (ESWL) due to left sided urinary lithiasis. 20 hours later he presented with left lower quadrant abdominal pain.
Investigations:
Ultrasound examination revealed free intraabdominal air and free perisplenic fluid. An injury of the left kidney could be excluded.
Treatment And Course:
Due to increasing abdominal pain a laparoscopy was performed, revealing a faecal peritonitis. Since no perforation could be detected laroscopically, a laparotomy was performed, demonstrating a perforation of the descending colon. The perforation was oversewn, a defunctioning colostomy was not performed. Postoperatively the patient had an uncomplicated hospital stay and was discharged home on postoperative day 8.
Conclusion:
ESWL is considered a safe method to treat urinary lithiasis with a low complication rate. Nevertheless serious potentially life-threatening pararenal complications can occur. Due to the increasing number of outpatient procedures, a careful clinical and ultrasound monitoring of the patient with early recognition and interdisciplinary management of complications is necessary after each ESWL therapy.
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