Ces Urol 2009, 13(3):217-222 | DOI: 10.48095/cccu2009016

Ruptured kidney as complication of extracorporeal shock wave lithotripsy

Tomáš Ürge¹, Jiří Kouba¹, Jan Jambura¹, Milan Hora¹, Václav Havel², Tomáš Skalický³

¹ Urologická klinika LF UK a FN Plzeň

² Radiodiagnostické oddělení LF UK a FN Plzeň

³ Chirurgická klinika LF UK a FN Plzeň

Objective: Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive method for renal stone treatment. Major complications are: rupture of kidney, spleen and cauda of pancreas. We present two cases of these complications, which demanding urgent surgery.
Case 1: Woman, 58 year old, with 6 mm lithiasis in pelviureteral junction of right kidney was carried out the endoscopic relocation of stone, emposed double loop ureteral stent and ESWL with desintegration of lithiasis. The complication was retroperitoneal haematoma. We performed suture of dorsal renal lip and evacuated haematoma. Woman was released 7 days after surgery and ureteral stent was removed 4 weeks later. We did not prove residual lithiasis; we suppose its spontaneous leaving.
Case 2: Man, 36 years old, with Crohn disease use using cyclic parenteral nutrition for syndrome of short limited intestine. The complications were steatosis of liver, cholecystolithiasis and bilateral nephrolithiasis. ESWL with its desintegration on the right side was carried out without complications in March 2008. ESWL with partial desintegration on the left side was performed in September 2008. The complication was renal subcapsular haematoma. We conducted surgery for progression 2 days later, suture of ruptured kidney pancreas and spleen. The next complication was malnutrition and formation of perirenal and intraabdominal infectious haematoma. Surgery with splenectomy and empossing double loop ureteral stent was necessary.

Conclusion: We can present these cases for severe complications after therapy which are known as non-invasive and safe. The cases confirm necessity of monitoring patients after ESWL.

Keywords: extracorporeal lithotripsy, retroperitonea haematoma, rupture of kidney

Received: February 3, 2009; Accepted: April 16, 2009; Published: June 1, 2009