Korean J Urol.  2010 Mar;51(3):212-215.

Life-Threatening Complication after Extracorporeal Shock Wave Lithotripsy for a Renal Stone: A Hepatic Subcapsular Hematoma

• Kim TB
• Park HK
• Lee KY
• Kim KH
• Jung H
• Yoon SJ

Abstract

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of urolithiasis since it was first introduced in 1980. ESWL is a well-established, safe and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. We present a case of a young female patient who developed a huge hepatic subcapsular hematoma accompanied by hypovolemic shock after ESWL for a 9 mm stone in the right kidney. The hematoma measured 13x6 cm. Conservative care with no surgical intervention was chosen because there was no evidence of active bleeding on the computed tomography. After conservative therapy, the hematoma was gradually absorbed and the patient was discharged.

Keyword

Lithotripsy; Hematoma; Complications

MeSH Terms

Female
Hematoma
Hemorrhage
Humans
Kidney
Lithotripsy
Shock
Urolithiasis

Figure

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  FIG. 1 (A) Before extracorporeal shock wave lithotripsy (ESWL), the kidney, ureter, and bladder radiography (KUB) revealed a 9 mm renal stone in the right kidney (arrow). (B) Before ESWL, the intravenous pyelography (IVP) revealed no hydronephrosis or excretion abnormality.

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  FIG. 2 (A) The axial and (B) vertical images of the computed tomography (CT) showing a large (13×6 cm) subcapsular hepatic hematoma.

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  FIG. 3 (A) Two months after extracorporeal shock wave lithotripsy (ESWL), the CT scan revealed a decreased size of the subcapsular hepatic hematoma. (B) Five months after ESWL, the subcapsular hematoma had been markedly resorbed and presented in a resolving state.

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