Trauma case reports · 2025
Lithotripsy-induced splenic injury requiring emergent splenectomy at a level 1 trauma center.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Goss Matthew B, Banton Joseph S, McGilvray Martha M O, Armocida Stephanie M, Kumar Arvind, Schuerer Douglas J E, McHale Matthew J
Аннотация
BACKGROUND: An exceptional occurrence, clinically-significant splenic injury secondary to extracorporeal shock wave lithotripsy (ESWL) is limited to 13 published reports since 1980.
CASE REPORT: 62-year-old female underwent ESWL targeting 5 mm ureteral stone at proximal left ureter. Following same-day discharge, medication-refractory abdominal pain precipitated emergency room visit where hypotensive with concern for acute abdomen. Of note, patient denied recent trauma to abdominal region. Imaging revealed acute splenic subcapsular hematoma and hemoperitoneum. Transferred to our institution for higher level of care. Hemodynamic instability with ongoing transfusion requirements and diffuse peritonitis dictated emergent procession to operating room, foregoing consideration of splenic artery embolization.
CONCLUSIONS: Splenic injury is an exceedingly rare, potentially life-threatening complication of ESWL. We feature the 4th report since 2020 and 14th overall since practice inception in 1980. Despite the resources of a large level 1 trauma center, our case highlights non-operative management may not be pragmatic in the emergent circumstance. Patient and provider education and early recognition remain key to optimize outcomes.
CASE REPORT: 62-year-old female underwent ESWL targeting 5 mm ureteral stone at proximal left ureter. Following same-day discharge, medication-refractory abdominal pain precipitated emergency room visit where hypotensive with concern for acute abdomen. Of note, patient denied recent trauma to abdominal region. Imaging revealed acute splenic subcapsular hematoma and hemoperitoneum. Transferred to our institution for higher level of care. Hemodynamic instability with ongoing transfusion requirements and diffuse peritonitis dictated emergent procession to operating room, foregoing consideration of splenic artery embolization.
CONCLUSIONS: Splenic injury is an exceedingly rare, potentially life-threatening complication of ESWL. We feature the 4th report since 2020 and 14th overall since practice inception in 1980. Despite the resources of a large level 1 trauma center, our case highlights non-operative management may not be pragmatic in the emergent circumstance. Patient and provider education and early recognition remain key to optimize outcomes.