[An unusual complication of extracorporeal shock wave lithotripsy: rupture of the kidney with consecutive nephrectomy].
BACKGROUND
Extracorporeal shockwave lithotripsy (ESWL) plays a major role in the treatment of urolithiasis. It has a high success rate, and spectrum and incidence of treatment-related morbidity are low.


METHODS
A 66-year-old male patient underwent ESWL treatment for an 8 mm medium-sized stone in the left kidney. During the subsequent post-interventional phase he experienced persistent flank pain, macrohematuria and protracted hemodynamic instability. An acute CT scan displayed a massive kidney rupture. Emergency lumbar exploration of the left kidney revealed multiple lacerations in the renal parenchyma and a nephrectomy was carried out.


CONCLUSIONS
This is the second internationally reported case study in which nephrectomy was necessitated after ESWL treatment due to multiple ruptures of the kidney. In view of the increasing use of ESWL in outpatient care, it is important that this potential complication is recognized and its clinical aspects appropriately assessed. The conclusion of the report comprises a concise review of the most severe complications in the immediate period after ESWL.
May
M
M
Urologische Klinik des CTK Cottbus.
Gunia
S
S
Helke
C
C
Seehafer
M
M
Hoschke
B
B
D000368:Aged; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000293:injuries*; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D009392:Nephrectomy; D012187:Retroperitoneal Space; D012421:Rupture; D014057:Tomography, X-Ray Computed