Conde Redondo Consuelo, Estebanez Zarranz Javier, Amón Sesmero José, Manzanas Manolo, Alonso Fernández Daniel, Rodríguez Toves Luis Antonio, Martínez Sagarra José María
Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España.
Arch Esp Urol. 2002 Oct;55(8):943-6.
To emphasise a case of splenic hematoma secondary to ESWL.
We report the case of a 69 year old patient with the diagnosis of left kidney stone who underwent ESWL. The treatment was performed with an electric lithotripter after pre-treatment antibiotic prophylaxis; 2000 shock waves of 18 Kv were given to the patient.
Patient presented abdominal pain and hematocrit descent after lithotripsy. The diagnosis of splenic hematoma was established after abdominal ultrasound and CT-scan and the patient was treated conservatively. He required a posterior emergency splenectomy secondary to infection of the hematoma, with the result of death secondary to septic shock.
Splenic lesion is an exceptional complication after ESWL. There are no studies about the effect of shock waves on the spleen, having been reported only four cases. It is believed that extreme care should be taken in cases with splenic pathology: leukaemia, lymphoma, etc.
强调1例体外冲击波碎石术（ESWL）继发脾血肿的病例。
我们报告1例69岁诊断为左肾结石并接受ESWL治疗的患者。在进行预处理抗生素预防后，使用电动碎石机进行治疗；给予患者2000次18千伏的冲击波。
患者碎石术后出现腹痛和血细胞比容下降。经腹部超声和CT扫描确诊为脾血肿，患者接受保守治疗。由于血肿感染，他随后需要进行急诊脾切除术，最终因感染性休克死亡。
脾损伤是ESWL后罕见的并发症。目前尚无关于冲击波对脾脏影响的研究，仅报道过4例。据信，对于有脾脏病变（如白血病、淋巴瘤等）的病例应格外小心。
