Bowel Perforation after Extracorporeal Wave Lithotripsy : A Review of the Literature
Fontanet, Sofia (Fundació Puigvert)
Farré, Alba (Fundació Puigvert)
Angerri, Oriol (Institut de Recerca Sant Pau)
Kanashiro, Andrés (Fundació Puigvert)
Suquilanda, Edgar (Fundació Puigvert)
Bollo, Jesús (Institut de Recerca Sant Pau)
Gallego, Maria (Universitat Autònoma de Barcelona)
Sánchez-Martín, Francisco Maria (Fundació Puigvert)
Millán, Félix (Fundació Puigvert)
Palou, Juan (Institut de Recerca Sant Pau)
Bonnin, Diana (Fundació Puigvert)
Emiliani, Esteban (Institut de Recerca Sant Pau)

Data:	2023
Resum:	Introduction: Extracorporeal wave lithotripsy (ESWL) is considered a first-line treatment for renal and ureteral stones up to 10-20 mm in diameter. Complications are uncommon, with a reported rate of 0-6% in the literature. Bowel perforation has only been described in a few case reports but requires rapid diagnosis and treatment. Methods: A review of the literature from PubMed/Medline, Embase, Cochrane, and Web of Science databases was performed including studies reporting bowel perforation secondary to ESWL between January 1990 and June 2022. Results: We found 16 case reports of intestinal perforation in the literature. Although some patients had previously undergone abdominal surgery or had inflammatory intestinal disease, others were without comorbidities that could lead to complications. Abdominal pain was the main symptom and imaging was required to confirm the diagnosis, which usually necessitated a surgical intervention. As regards the ESWL technique, it appears that the combination of a high energy level and the prone position constitutes a risk factor for these rare complications. At the authors' centre, only one case has been reported among 24,000 ESWL procedures over 20 years: A 59-year-old female who underwent ESWL for a distal right ureteral stone presented acute abdominal pain and free intraperitoneal pelvic fluid on ultrasound. A CT scan revealed a small bowel perforation requiring open laparotomy with primary closure. Conclusions: In conclusion, although bowel perforation after ESWL is rare, progressive abdominal pain with tenderness at physical examination requires proper imaging evaluation to exclude bowel perforation and prompt intervention if required.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	ESWL ; Lithotripsy ; Stone ; Urology ; Bowel perforation
Publicat a:	Journal of clinical medicine, Vol. 12 (january 2023) , ISSN 2077-0383

DOI: 10.3390/jcm12031052
PMID: 36769699

8 p, 267.0 KB

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