Acute pancreatitis caused by extracorporeal shock wave lithotripsy for bilateral renal pelvic calculi

Citation
H. Abe et al., Acute pancreatitis caused by extracorporeal shock wave lithotripsy for bilateral renal pelvic calculi, INT J UROL, 7(2), 2000, pp. 65-68
Citations number
5
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
Journal title
INTERNATIONAL JOURNAL OF UROLOGY
ISSN journal
0919-8172 → ACNP
Volume
7
Issue
2
Year of publication
2000
Pages
65 - 68
Database
ISI
SICI code
0919-8172(200002)7:2<65:APCBES>2.0.ZU;2-5
Abstract
An elderly woman with a history of cholecystectomy and a re-operation for p ostoperative peritonitis underwent extracorporeal shock wave lithotripsy (E SWL) for right and left renal pelvic calculi, 11 x 6 and 12 x 5 mm in size, to which 2400 and 1400 shots at 20 kV were given, respectively, on the sam e day. During the evening after the operation, the patient started to compl ain of upper abdominal pain. Laboratory examination on the next day reveale d elevations in blood and urine amylase levels and a diagnosis of pancreati tis was made. Conservative treatment, including administration of protease inhibitor, did not improve her symptoms; abdominal distension became marked and she underwent laparotomy. Necrosection and indwelling of several drain tubes in abdomen were performed with an operative diagnosis of acute necro tic pancreatitis. With daily irrigation of drain tubes and treatment for me thicillin-resistant Staphyloococcus aureus the lungs and abdominal cavity, septicemia and duodenal fistula, the patient gradually recovered and was di scharged on postoperative day 151. It was suggested that ESWL was responsib le for the acute pancreatitis. Either an obstruction of the pancreatic duct by fragments of common duct stone, or mechanical injury of the pancreas du e to adhesion between the pancreas and surrounding tissue caused by the lap alotomy, was considered as a possible cause of pancreatitis. To our knowled ge, there has been no previous report of severe acute pancreatitis and the present case suggests that ESWL may cause severe pancreatic even in cases w ithout stone shadow in the bile, common duct or pancreatic duct.