The effect of high-dose right upper quadrant lithotripsy on normal swine tissue

To assess the effects of high doses of shock waves to organs in the right upper quadrant of the abdomen, 36 adolescent swine were given one treatment of either 2,000 (2k), 6,000 (6k), or 10,000 (10k) shock waves at 24 kV peak pressure using a spark-gap lithotriptor. Shock waves were sonographically focused on the lumen of the gallbladder. Blood and tissue were examined for each group at 48 hours, at 35 days, and at 6 months. This study showed that administration of up to five times the accepted upper limit of shock waves produced no permanent damage. Transient injury, most commonly hematoma, was encountered. No posttreatment intra-abdominal catastrophes occurred. Although no renal injury was seen, it should be noted that the focus of maximum energy was 5 cm cephalad to the right kidney. This study suggests that an increased number of shock waves may be administered safely to this area of the abdomen.