4b4e92db3b35e5ad26a7a549725a6c34 pmc_9917583.pdf 7fd71ce7766e3696e0d738914fec1475f967695a pmc_9917583.pdf b7688c38f0a980024aa64be8686adcdd8fcb859be7b1590e6e59906f8b55fd08 pmc_9917583.pdf Title: Bowel Perforation after Extracorporeal Wave Lithotripsy: A Review of the Literature Subject: 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. Keywords: ESWL; lithotripsy; stone; urology; bowel perforation Author: Sofia Fontanet, Alba Farré, Oriol Angerri, Andrés Kanashiro, Edgar Suquilanda, Jesús Bollo, Maria Gallego, Francisco Maria Sánchez-Martín, Félix Millán, Joan Palou, Diana Bonnin and Esteban Emiliani Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Feb 2 04:23:44 2023 CET ModDate: Thu Feb 2 04:26:28 2023 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 8 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 273369 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OSMCID+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 OPZDHV+VnURWPalladioL Type 1 Custom yes yes no 15 0 JVKQVP+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 DCXCMQ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 TKJPCZ+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 DVCMRV+CMSY10 Type 1 Builtin yes yes no 74 0 SYVAVM+VnURWPalladioL-Italic Type 1 Custom yes yes no 90 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-17 02:31:25 CEST RepresentationInformation: pmc_9917583.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-04-22 02:23:42 CEST Size: 273369 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 242 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Info: Title: Bowel Perforation after Extracorporeal Wave Lithotripsy: A Review of the Literature Author: Sofia Fontanet, Alba Farré, Oriol Angerri, Andrés Kanashiro, Edgar Suquilanda, Jesús Bollo, Maria Gallego, Francisco Maria Sánchez-Martín, Félix Millán, Joan Palou, Diana Bonnin and Esteban Emiliani Subject: 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. 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