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Serious Complications Following Lithotripsy - An Iatrogenic Injury Need to Be Care for

Received: 16 June 2020     Accepted: 15 July 2020     Published: 4 August 2020
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Abstract

Between November 2007 and July 2019, four cases with serious complications after ESWL were transfer to our emergency department, the First Hospital of Lanzhou University, a western Hospital of China. Because urosepsis, hypovolemic shock or acute renal function failure, three of these patients died within 14.5 hours (14.5 hours, 48 minutes, and 58 minutes, respectively, mean 5.4 h) after they were admitted. The ESWL missions for these three patients were 4, 7 and 5, with a time interval of 2, 4 and 4 weeks accordingly. An exploratory laparotomy had to perform on the last patient and a ruptured left kidney was confirmed accompany with pyogenic infection during the operation. She died at the seventh day after been admitted. So iatrogenic injury caused by over-treatment and without systemic follow up may be the main cause of these death cases. Clinical data were summarized and literature was reviewed. We found, although ESWL is a simple, safe and effective procedure for the management of urolithiasis, unnecessary hurt will occur when it was used inappropriately. So indispensable attention must be pay on its possible side effects, especially for over-treatment. Well-trained ESWL physicians may be necessary for ESWL profession, which may reduce the incidence rate of severe complications in the ESWL treatment effectively.

Published in International Journal of Clinical Urology (Volume 4, Issue 2)
DOI 10.11648/j.ijcu.20200402.15
Page(s) 59-63
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Extracorporeal Shock Wave Lithotripsy (ESWL), Urolithiasis, Serious Complication, Over-treatment, Iatrogenic Injury

References
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[2] Friedersdorff, F., Buckendahl, J., Fuller, T. F., Cash, H., Extracorporeal shock wave lithotripsy (ESWL) of a renal calculus in a liver transplant recipient: report of a severe complication--a case report. Transplant Proc. Nov 42 (9): p. 3868-70.
[3] Inoue, H., Kamphausen, T., Bajanowski, T., Trubner, K., Massive retroperitoneal haemorrhage after extracorporeal shock wave lithotripsy (ESWL). Int J Legal Med. 125 (1): p. 75-9.
[4] Turgut, M., Can, C., Yenilmez, A., Akcar, N., Perforation of the upper ureter: a rare complication of extracorporeal shock wave lithotripsy. Urol Res, 2007. 35 (4): p. 215-8.
[5] Uemura, K., Takahashi, S., Shintani-Ishida, K., Nakajima, M., Saka, K., Yoshida, K., A death due to perirenal hematoma complicating extracorporeal shockwave lithotripsy. J Forensic Sci, 2008. 53 (2): p. 469-71.
[6] Doran, O. and B. Foley, Acute complications following extracorporeal shock-wave lithotripsy for renal and ureteric calculi. Emerg Med Australas, 2008. 20 (2): p. 105-11.
[7] Turna, B., Akbay, K., Ekren, F., Nazli, O., Apaydin, E., Semerci, B., Gunaydin, G., Cureklibatir, I., Comparative study of extracorporeal shock wave lithotripsy outcomes for proximal and distal ureteric stones. Int Urol Nephrol, 2008. 40 (1): p. 23-9.
[8] Liu, Y. D., Yuan, J., Li, X., Luo, J. T., Zeng, G. H., Wu, K. J., [Complications of minimally-invasive percutaneous nephrolithotomy]. Zhonghua Wai Ke Za Zhi, 2008. 46 (3): p. 200-2.
[9] Skolarikos, A., G. Alivizatos, and J. de la Rosette, Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol, 2006. 50 (5): p. 981-90; discussion 990.
[10] Sighinolfi, M. C., Micali, S., Grande, M., Mofferdin, A., De Stefani, S., Bianchi, G., Extracorporeal shock wave lithotripsy in an elderly population: how to prevent complications and make the treatment safe and effective. J Endourol, 2008. 22 (10): p. 2223-6.
[11] Shouman, A. M., Ziada, A. M., Ghoneim, I. A., Morsi, H. A., Extracorporeal Shock Wave Lithotripsy Monotherapy for Renal Stones >25 mm in Children. Urology, 2009.
[12] Fujita, K., Mizuno, T., Ushiyama, T., Suzuki, K., Hadano, S., Satoh, S., Kambayashi, T., Mugiya, S., Nakano, M., Complicating risk factors for pyelonephritis after extracorporeal shock wave lithotripsy. Int J Urol, 2000. 7 (6): p. 224-30.
[13] Joshi, H. B., O. O. Obadeyi, and P. N. Rao, A comparative analysis of nephrostomy, JJ stent and urgent in situ extracorporeal shock wave lithotripsy for obstructing ureteric stones. BJU Int, 1999. 84 (3): p. 264-9.
[14] Al-Awadi, K. A., Abdul Halim, H., Kehinde, E. O., Al-Tawheed, A., Steinstrasse: a comparison of incidence with and without J stenting and the effect of J stenting on subsequent management. BJU Int, 1999. 84 (6): p. 618-21.
[15] Beatrice, J., Strebel, R. T., Pfammatter, T., Rohweder, J. H., Sulser, T., Life-threatening complication after right renal extracorporeal shock wave lithotripsy: large hepatic haematoma requiring embolisation of the right hepatic artery. Eur Urol, 2007. 52 (3): p. 909-11.
[16] Gallagher, H. J. and D. A. Tolley, 2000 AD: still a role for the intravenous urogram in stone management? Curr Opin Urol, 2000. 10 (6): p. 551-5.
[17] Abe, H., Nisimura, T., Osawa, S., Miura, T., Oka, F., Acute pancreatitis caused by extracorporeal shock wave lithotripsy for bilateral renal pelvic calculi. Int J Urol, 2000. 7 (2): p. 65-8.
[18] Kurz, W., B. Klein, and B. Rumstadt, [Colonic perforation after extracorporeal shock wave lithotripsy.]. Dtsch Med Wochenschr, 2009. 134 (9): p. 401-3.
[19] Kurtz, V., M. Muller-Sorg, and G. Federmann, [Perforation of the small intestine after nephro-uretero-lithotripsy by ESWL--a rare complication]. Chirurg, 1999. 70 (3): p. 306-7.
[20] Neri, E., Capannini, G., Diciolla, F., Carone, E., Tripodi, A., Tucci, E., Sassi, C., Localized dissection and delayed rupture of the abdominal aorta after extracorporeal shock wave lithotripsy. J Vasc Surg, 2000. 31 (5): p. 1052-5.
[21] Treglia, A. and M. Moscoloni, Irreversible acute renal failure after bilateral extracorporeal shock wave lithotripsy. J Nephrol, 1999. 12 (3): p. 190-2.
[22] Iwamoto, I., Yonekawa, S., Takeda, T., Sakaguchi, M., Ohno, T., Tanaka, H., Hasegawa, H., Imada, A., Horiuchi, A., Umekawa, T., Kurita, T., Anti-glomerular basement membrane nephritis after extracorporeal shock wave lithotripsy. Am J Nephrol, 1998. 18 (6): p. 534-7.
[23] Sellin, L., Quack, I., Weiner, S. M., Waldherr, R., Henning, B., Hofebauer, S., Rump, L. C., Nephrolithiasis and hematuria--sometimes a stony road to diagnosis. Clin Nephrol, 2005. 64 (2): p. 151-4.
[24] Lottmann, H. B., Archambaud, F., Traxer, O., Mercier-Pageyral, B., Helal, B., The efficacy and parenchymal consequences of extracorporeal shock wave lithotripsy in infants. BJU Int, 2000. 85 (3): p. 311-5.
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  • APA Style

    Xiangbo Zhang, Wei Zhang. (2020). Serious Complications Following Lithotripsy - An Iatrogenic Injury Need to Be Care for. International Journal of Clinical Urology, 4(2), 59-63. https://doi.org/10.11648/j.ijcu.20200402.15

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    ACS Style

    Xiangbo Zhang; Wei Zhang. Serious Complications Following Lithotripsy - An Iatrogenic Injury Need to Be Care for. Int. J. Clin. Urol. 2020, 4(2), 59-63. doi: 10.11648/j.ijcu.20200402.15

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    AMA Style

    Xiangbo Zhang, Wei Zhang. Serious Complications Following Lithotripsy - An Iatrogenic Injury Need to Be Care for. Int J Clin Urol. 2020;4(2):59-63. doi: 10.11648/j.ijcu.20200402.15

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  • @article{10.11648/j.ijcu.20200402.15,
      author = {Xiangbo Zhang and Wei Zhang},
      title = {Serious Complications Following Lithotripsy - An Iatrogenic Injury Need to Be Care for},
      journal = {International Journal of Clinical Urology},
      volume = {4},
      number = {2},
      pages = {59-63},
      doi = {10.11648/j.ijcu.20200402.15},
      url = {https://doi.org/10.11648/j.ijcu.20200402.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20200402.15},
      abstract = {Between November 2007 and July 2019, four cases with serious complications after ESWL were transfer to our emergency department, the First Hospital of Lanzhou University, a western Hospital of China. Because urosepsis, hypovolemic shock or acute renal function failure, three of these patients died within 14.5 hours (14.5 hours, 48 minutes, and 58 minutes, respectively, mean 5.4 h) after they were admitted. The ESWL missions for these three patients were 4, 7 and 5, with a time interval of 2, 4 and 4 weeks accordingly. An exploratory laparotomy had to perform on the last patient and a ruptured left kidney was confirmed accompany with pyogenic infection during the operation. She died at the seventh day after been admitted. So iatrogenic injury caused by over-treatment and without systemic follow up may be the main cause of these death cases. Clinical data were summarized and literature was reviewed. We found, although ESWL is a simple, safe and effective procedure for the management of urolithiasis, unnecessary hurt will occur when it was used inappropriately. So indispensable attention must be pay on its possible side effects, especially for over-treatment. Well-trained ESWL physicians may be necessary for ESWL profession, which may reduce the incidence rate of severe complications in the ESWL treatment effectively.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Serious Complications Following Lithotripsy - An Iatrogenic Injury Need to Be Care for
    AU  - Xiangbo Zhang
    AU  - Wei Zhang
    Y1  - 2020/08/04
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijcu.20200402.15
    DO  - 10.11648/j.ijcu.20200402.15
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 59
    EP  - 63
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20200402.15
    AB  - Between November 2007 and July 2019, four cases with serious complications after ESWL were transfer to our emergency department, the First Hospital of Lanzhou University, a western Hospital of China. Because urosepsis, hypovolemic shock or acute renal function failure, three of these patients died within 14.5 hours (14.5 hours, 48 minutes, and 58 minutes, respectively, mean 5.4 h) after they were admitted. The ESWL missions for these three patients were 4, 7 and 5, with a time interval of 2, 4 and 4 weeks accordingly. An exploratory laparotomy had to perform on the last patient and a ruptured left kidney was confirmed accompany with pyogenic infection during the operation. She died at the seventh day after been admitted. So iatrogenic injury caused by over-treatment and without systemic follow up may be the main cause of these death cases. Clinical data were summarized and literature was reviewed. We found, although ESWL is a simple, safe and effective procedure for the management of urolithiasis, unnecessary hurt will occur when it was used inappropriately. So indispensable attention must be pay on its possible side effects, especially for over-treatment. Well-trained ESWL physicians may be necessary for ESWL profession, which may reduce the incidence rate of severe complications in the ESWL treatment effectively.
    VL  - 4
    IS  - 2
    ER  - 

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Author Information
  • Department of Urology, the First Hospital of Lanzhou University, Lan Zhou, P. R. China

  • Department of Urology, the First Hospital of Lanzhou University, Lan Zhou, P. R. China

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