Shock wave lithotripsy-induced renal injury

Case contributed by Dr Sigmund Stuppner

Presentation

Patient underwent SWL for left sided renal stone.

Patient Data

Age: 44
Gender: Female

Left sided renal stone.

Fragmented left sided kidney stones. Left renal subcapsular haematoma with signs of parenchymal hypoperfusion and parenchymal compression.  The acute vascular injury of SWL caused an extracapsular hematoma, too. Tissue injury as a result of shock waves caused discontinuity of Gerota's fascia and peri/pararenal hematoma. Anterior displacement of the pancreas tail.

There is also free perisplenic fluid.  Free fluid along the lateroconal fascia and in the left iliac fossa, too. Left pleural effusion.

Case Discussion

Experimental reports clearly show that shock wave lithotripsy (SWL) causes adverse acute renal effects in a majority, if not all, treated kidneys. SWL-induced acute renal injury may result in severe injury to the nephron, microvasculature, and the surrounding interstitium.

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Case information

rID: 47211
Case created: 4th Aug 2016
Last edited: 30th May 2017
System: Urogenital
Inclusion in quiz mode: Included

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