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Severe perinephric hemorrhage after shockwave lithotripsy
N K Antoniou1, D Karanastasis, J L Stenos
1Department of Surgery, ELPIS General Hospital of Athens, Greece.
Journal of Endourology
|June 1, 1995
Summary
A patient experienced severe bleeding and flank pain after kidney stone treatment. This complication led to a nephrectomy, possibly due to undiagnosed chronic pyelonephritis.
Area of Science:
- Nephrology
- Urology
- Surgical Complications
Background:
- Shockwave lithotripsy is a common procedure for treating kidney stones.
- Multiple or large kidney stones may require multiple treatment sessions.
- Patient history and comorbidities are crucial for risk assessment.
Observation:
- A 69-year-old male underwent a second shockwave lithotripsy session for right kidney stones.
- Post-procedure, the patient developed severe hemorrhage and intractable flank pain.
- Extensive perinephric hematoma gradually formed, indicating significant bleeding.
Findings:
- The severe hemorrhage necessitated a nephrectomy (kidney removal).
- Unrecognized chronic pyelonephritis was suspected as a potential predisposing factor for the complication.
- This case highlights a rare but serious adverse event following lithotripsy.
Implications:
- Clinicians should consider potential complications of shockwave lithotripsy, especially in patients with underlying renal conditions.
- Thorough pre-operative evaluation may help identify patients at higher risk for hemorrhage.
- Prompt recognition and management of perinephric hematoma are critical to improve patient outcomes.