Life-Threatening Complication after Right Renal Extracorporeal Shock Wave Lithotripsy: Large Hepatic Haematoma Requiring Embolisation of the Right Hepatic Artery

Beatrice, Josef; Strebel, Raeto T.; Pfammatter, Thomas; Röhweder, Jaime H.; Sulser, Tullio

doi:10.1016/j.eururo.2007.02.011

Cited by 19 publications

(12 citation statements)

References 7 publications

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“…With current apparatus, the clinician is ill-equipped to determine in-theatre whether the treatment has been successful, with the result that 30-50% of patients need to return for re-treatment, and an unknown number receive a greater exposure to shock waves than is necessary for stone fragmentation [2]. Overexposure carries the potential for adverse side effects [3][4][5][6]. There is therefore an imperative for the development of a non-invasive device for monitoring the progress of the therapy in real time in the clinic [7].…”

Section: Introductionmentioning

confidence: 99%

Prediction of far-field acoustic emissions from cavitation clouds during shock wave lithotripsy for development of a clinical device

et al. 2013

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This study presents the key simulation and decision stage of a multi-disciplinary project to develop a hospital device for monitoring the effectiveness of kidney stone fragmentation by shock wave lithotripsy (SWL). The device analyses, in real time, the pressure fields detected by sensors placed on the patient's torso, fields generated by the interaction of the incident shock wave, cavitation, kidney stone and soft tissue. Earlier free-Lagrange simulations of those interactions were restricted (by limited computational resources) to computational domains within a few centimetres of the stone. Later studies estimated the far-field pressures generated when those interactions involved only single bubbles. This study extends the free-Lagrange method to quantify the bubblebubble interaction as a function of their separation. This, in turn, allowed identification of the validity of using a model of non-interacting bubbles to obtain estimations of the far-field pressures from 1000 bubbles distributed within the focus of the SWL field. Up to this point in the multi-disciplinary project, the design of the clinical device had been led by the simulations. This study records the decision point when the project's direction had to be led by far more costly clinical trials instead of the relatively inexpensive simulations.

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Section: Introductionmentioning

confidence: 99%

Prediction of far-field acoustic emissions from cavitation clouds during shock wave lithotripsy for development of a clinical device

et al. 2013

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“…Several reports in the literature are present regarding the possible harmful effect of extracorporeal SWL on the kidneys and adjacent organs: the lungs, liver, pancreas, and intestine. [1][2][3][4][5] Perirenal hematoma with or without hematuria is the most common acute complication. Transient increase in intrarenal vascular resistance, diastolic blood pressure, and markers of tubular damage was reported after SWL.…”

mentioning

confidence: 99%

Electromagnetic and Electrohydraulic Shock Wave Lithotripsy-Induced Urothelial Damage: Is There a Difference?

Mustafa

Aburas

Helo

et al. 2017

Journal of Endourology

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Purpose: To evaluate and compare the acute effect of electromagnetic and electrohydraulic extracorporeal shockwave lithotripsy (SWL) on the urothelial layers of kidney and ureter. Materials and Methods: Fifty patients, 29 males (58%) and 21 females (42%), with an average age of 51.68 years (range: 37-70) who underwent SWL application in two different centers were included. Twenty-eight patients (56%) were treated with electrohydraulic and 22 (44%) were treated with electromagnetic lithotripsy. Urinary cytologic examinations were done immediately before and after SWL therapy and 10 days later. The average numbers of epithelial cells, red blood cells (RBC), and myocytes were counted under 40 · magnification. Results: There were significant differences in the number of epithelial cells and RBC before and after immediate application of SWL: 1.66 and 14.9 cells/field, ( p = 0.001), 5.44 and 113.45 cells/field, respectively ( p = 0.001). The number of RBC was significantly higher in patients treated with electromagnetic lithotripsy than those treated with electrohydraulic: 141.9 and 93.4 cells/field, respectively ( p = 0.02). No myocyte or basement membrane elements were detected in any of the cytologic examinations. Cytologic examinations done after 10 days of SWL therapy revealed recovery of all abnormal cytologic findings. Conclusions: The acute increments in the number of epithelial cells and RBC after SWL were statistically significant but it was not permanent. SWL-induced urinary urothelial lesion is limited to the mucosal layer and there was no evidence of damage to the basal membrane or muscle layer. Electromagnetic lithotripsy caused high numbers of RBC than the electrohydraulic device on the postimmediate urine cytologic examination.

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“…In the presence of haemodynamic compromise, despite resuscitation or in the presence of a rapidly expanding haematoma, an intervention should be undertaken. In the first instance, interventional radiology in the form of an arterial embolisation should be attempted 2 11 18. A surgical intervention should be considered where either a radiological intervention has failed or the haemodynamic compromise is life-threatening.…”

Section: Discussionmentioning

confidence: 99%

Golfer's swing leads to a spontaneous subcapsular liver haematoma

et al. 2013

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SUMMARYWe report the rare case of a patient presenting with a spontaneous hepatic subcapsular haematoma after playing golf. The patient had no underlying predisposing conditions. A CT scan of the abdomen/pelvis demonstrated a 1 cm deep low-attenuation subcapsular collection around the anterolateral aspect of the liver. The patient was treated conservatively and was discharged from inpatient care after 72 h. This is only the second reported case of a spontaneous subcapsular haematoma. BACKGROUND

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Life-Threatening Complication after Right Renal Extracorporeal Shock Wave Lithotripsy: Large Hepatic Haematoma Requiring Embolisation of the Right Hepatic Artery

Cited by 19 publications

References 7 publications

Prediction of far-field acoustic emissions from cavitation clouds during shock wave lithotripsy for development of a clinical device

Prediction of far-field acoustic emissions from cavitation clouds during shock wave lithotripsy for development of a clinical device

Electromagnetic and Electrohydraulic Shock Wave Lithotripsy-Induced Urothelial Damage: Is There a Difference?

Golfer's swing leads to a spontaneous subcapsular liver haematoma

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