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Related Experiment Videos

Biliary obstruction complicating extracorporeal shock wave lithotripsy.

A Krongrad1, A Kirschenbaum, B Saltzman

  • 1Department of Urology, Mount Sinai Medical Center, New York, New York 10029.

The Journal of Urology
|February 1, 1988
PubMed
Summary

Extracorporeal shock wave lithotripsy (ESWL) for kidney stones may fragment gallstones, leading to bile duct obstruction. This case highlights a potential complication of ESWL in patients with undiagnosed gallstones.

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Medical Devices

Background:

  • A patient with a solitary kidney and undiagnosed gallstones underwent extracorporeal shock wave lithotripsy (ESWL) for renal calculi.
  • Cholelithiasis (gallstones) can be asymptomatic and discovered incidentally.

Observation:

  • Post-ESWL, the patient developed biliary obstruction requiring emergency surgery.
  • Pathological examination of the biliary calculi showed superficial fragmentation.

Findings:

  • The fragmentation pattern of the gallstones suggests they were affected by the shock waves used during ESWL.
  • This fragmentation is hypothesized to have caused the subsequent bile duct obstruction.

Implications:

  • ESWL may pose a risk of gallstone fragmentation and biliary complications in patients with coexisting cholelithiasis.

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  • Preoperative screening for gallstones may be warranted in patients undergoing ESWL, especially those with risk factors.