Chen C S, Lai M K, Hsieh M L, Chu S H, Huang M H, Chen S J
Division of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1992 Dec;15(4):215-9.
Splenic trauma with hematoma following extracorporeal shock wave lithotripsy (ESWL) is very rare. We reported a case of subcapsular hematoma of spleen with impending rupture following ESWL for ureteral calculus. This case was noted to have liver cirrhosis and splenomegaly, and received a total of 2000 shock waves under 18 kilovoltage. The subcapsular hematoma occurred 2 months later. Splenectomy was undertaken for a symptomatic huge subcapsular hematoma and thrombocytopenia. We reviewed the literature and concluded that portal hypertension with severe coagulopathy are contraindications for ESWL, even in case with ureteral calculus.
体外冲击波碎石术(ESWL)后并发脾外伤伴血肿极为罕见。我们报告了1例输尿管结石行ESWL术后发生脾包膜下血肿且有破裂倾向的病例。该病例有肝硬化和脾肿大,在18千伏电压下共接受了2000次冲击波治疗。2个月后出现脾包膜下血肿。因出现症状性巨大脾包膜下血肿和血小板减少而行脾切除术。我们复习文献后得出结论,门静脉高压伴严重凝血功能障碍是ESWL的禁忌证,即使是输尿管结石病例。