Massive retroperitoneal haemorrhage after extracorporeal shock wave lithotripsy (ESWL).

International Journal of Legal Medicine
Hiromasa InoueKurt Trübner

Abstract

A 76-year-old male suffering from nephrolithiasis developed a shock syndrome 5 days after extracorporal shock wave lithotripsy (ESWL). CT scan of the abdomen showed massive haemorrhage around the right kidney. Although nephrectomy was performed immediately, the haemorrhage could not be controlled. Numerous units of erythrocytes were transfused, but the patient died. The autopsy revealed massive retroperitoneal haemorrhage around the right kidney. The kidney showed a subcapsular haematoma and a rupture of the capsule. The right renal artery was dissected. The inferior vena cava was lacerated. Accordingly, a hemorrhagic shock as the cause of death was determined, which might mainly have resulted from the laceration of the inferior vena cava due to ESWL. ESWL seems to be a relatively non-invasive modality, but one of its severe complications is perirenal hematoma. The injuries of the blood vessels might have been caused by excessive shock waves. Subsequently, anticoagulation therapy had been resumed 3 days after EWSL, which might have triggered the haemorrhage. Physicians should note that a haemorrhage after an ESWL can occur and they should pay attention to the postoperative management in aged individuals especially when they are...Continue Reading

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Citations

Jan 1, 2013·Journal of Endourology·Hsiang-ying LeeYung-Shun Juan
Mar 15, 2012·Current Urology Reports·Julie M Riley, Timothy D Averch
Jan 28, 2021·The Journal of International Medical Research·Hao-Tian TanChun-Hua Lin
Apr 16, 2021·Radiologia brasileira·Vinicius Adami Vayego FornazariDenis Szejnfeld

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