A case of fatal embolization during laser lithotripsy

Area of Science:

• Urology
• Nephrology
• Pathology

Background:

• Laser lithotripsy is a common procedure for treating ureteral stones.
• Complications, though rare, can be severe and life-threatening.

Observation:

• A tetraplegic patient undergoing laser lithotripsy for bilateral ureteral stones experienced sudden bradycardia and hypoxia.
• Despite immediate medical intervention, the patient suffered cardiocirculatory arrest and died.

Findings:

• Autopsy revealed massive embolization of ureteral calculus fragments in the lungs and heart.
• Disseminated intravascular coagulation secondary to calculus embolization was identified as the cause of death.

Implications:

• Ureteral stone fragment embolization is an unpredictable and difficult-to-diagnose complication of laser lithotripsy.
• Histopathological examination is crucial for confirming lethal embolization and determining the cause of death.