Large mesenteric hematoma after extracorporeal shock wave lithotripsy for pancreatic stones

Liu, Yu; Liang, Hao; Wang, Lisheng; Wang, Teng; Li, Zhao‐Shen; Hu, Liang‐Hao; Xu, Zefeng

doi:10.1097/md.0000000000013114

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…16 Other studies have reported rare complications such as gastric submucosal hematoma 17 and mesenteric hematoma after ESWL. 18 These complications may affect the success of selective deep cannulation and stone clearance under subsequent endoscopic treatment.…”

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confidence: 99%

Optimal Timing of Endoscopic Intervention After Extracorporeal Shock-Wave Lithotripsy in the Treatment of Chronic Calcified Pancreatitis

Guo

Qian

Sun³

et al. 2021

Pancreas

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Objectives:The interval between extracorporeal shock-wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP) may cause differences in cannulation and stone removal. This study was to investigate the optimal timing of ERCP after ESWL.Methods: Patients with chronic calcified pancreatitis, who underwent ESWL and subsequent ERCP in Changhai Hospital from February 2012 to February 2015, were retrospectively analyzed. The interval between ESWL and ERCP was used to divide patients into groups A (<12 hours), B (12-36 hours), and C (>36 hours). Cannulation success, stone clearance, and post-ESWL/ERCP complications were compared.Results: A total of 507 patients were enrolled. There were no significant differences regarding the successful cannulation and stone removal rates between the 3 groups. In patients without prior ERCP, the successful cannulation rates were 71.4%, 81.9%, and 90.9% (P = 0.004), and the successful clearance rates were 76.2%, 85.1%, and 90.9% (P = 0.031) for these 3 groups, respectively, showing significant differences. There were no differences in the successful cannulation and stone extraction rates for patients with prior ERCP. Conclusions:The interval between ESWL and ERCP in chronic calcified pancreatitis patients with prior ERCP is not relevant, while delaying endoscopic intervention is recommended in those with native papilla.

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confidence: 99%

Optimal Timing of Endoscopic Intervention After Extracorporeal Shock-Wave Lithotripsy in the Treatment of Chronic Calcified Pancreatitis

Guo

Qian

Sun³

et al. 2021

Pancreas

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“…The overall complication rate was 6.7%, including pancreatitis, bleeding, infection, steinstrasse, and perforation. [ 6 ] Rare complications have also been reported, such as hepatic subcapsular hematoma, [ 3 ] splenic hematoma, [ 7 ] colonic hematoma, [ 8 ] large mesenteric hematoma, [ 9 ] and pancreaticobiliary fistula. [ 10 ] Lung contusion has been reported after urinary ESWL, [ 11 ] but to our knowledge, lung contusion has never been reported after P-ESWL.…”

Section: Discussionmentioning

confidence: 99%

Lung contusion after extracorporeal shock wave lithotripsy for pancreatic stones: A case report

Wang

Chen

et al. 2022

Medicine

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Background: Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is recommended as the first-line treatment for large pancreatic stones. While complications such as post-P-ESWL pancreatitis, bleeding, infection, steinstrasse, and perforation have been reported in the past 30 years, lung contusion has never been reported. The present case demonstrates lung contusion as a complication after P-ESWL. Methods: A 48-year-old man was admitted to our department due to painful chronic pancreatitis with pancreatic duct stones. Computed tomography revealed normal lungs. P-ESWL was performed. The shock wave head contacted with right upper quadrant and the path of shock wave was at a 45° angle to the ventral midline. After P-ESWL, multiple patchy high-density shadows in the lower lobe of right lung were found, which was normal before P-ESWL. The patient had no symptoms of lung injury. Results and Conclusion: Laboratory studies revealed elevated D-dimer from 0.33 to 0.74 ug/mL, which was consistent with abnormal clotting of lung contusion. Chest computed tomography showed slight pleural effusion. Considering the interval between 2 X-rays was only 3 hours, we inferred that lung contusion was related to P-ESWL. The patient displayed stable vital signs, therefore, no specific interventions were conducted. Three days after P-ESWL, endoscopic retrograde cholangiopancreatography was performed and the lung shadows were partially absorbed. Considering the location of shock wave head, it was possible to cause lung contusion in lower lobe of right lung. More than 10,000 P-ESWL therapeutic sessions had been performed in our center since 2010, and it is the first case about lung contusion as a complication. It is also the first report to describe lung contusion after P-ESWL. Although the patient was asymptomatic, it should raise awareness of clinicians.

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“…Different from post-ERCP gastrointestinal bleeding, such as duodenal bulb injury or postsphincterotomy bleeding, post-ESWL bleeding is defined as bleeding in a closed chamber due to shock wave damage in peripancreatic organs, including hepatic subcapsular haematoma, mesenteric haematoma, colonic haematoma, gastric submucosal haematoma and renal subcapsular haemorrhage [29][30][31][32][33]. Bleeding often occurs immediately or within a few hours after P-ESWL.…”

Section: Manifestations and Management Of Complicationsmentioning

confidence: 99%

Adverse events of pancreatic extracorporeal shock wave lithotripsy: a literature review

Yi,

Li,

2023

BMC Gastroenterol

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Pancreatic stones are the result of pathophysiologic changes in chronic pancreatitis with an incidence of more than 90%. At present, pancreatic extracorporeal shock wave lithotripsy (P-ESWL) can be used as the first-line treatment for large or complex stones. Although a large number of studies have proven the safety and effectiveness of P-ESWL, we should also pay attention to postoperative adverse events, mainly due to the scattering of shock waves in the conduction pathway. Adverse events can be classified as either complications or transient adverse events according to the severity. Because the anatomic location of organs along the shock wave conducting pathway differs greatly, adverse events after P-ESWL are varied and difficult to predict. This paper outlines the mechanism, definition, classification, management and risk factors for adverse events related to P-ESWL. It also discusses the technique of P-ESWL, indications and contraindications of P-ESWL, and adverse events in special populations.

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Large mesenteric hematoma after extracorporeal shock wave lithotripsy for pancreatic stones

Cited by 6 publications

References 29 publications

Optimal Timing of Endoscopic Intervention After Extracorporeal Shock-Wave Lithotripsy in the Treatment of Chronic Calcified Pancreatitis

Optimal Timing of Endoscopic Intervention After Extracorporeal Shock-Wave Lithotripsy in the Treatment of Chronic Calcified Pancreatitis

Lung contusion after extracorporeal shock wave lithotripsy for pancreatic stones: A case report

Adverse events of pancreatic extracorporeal shock wave lithotripsy: a literature review

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