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Diagnostic and prognostic role of computed tomography in extracorporeal shock wave lithotripsy complications
| Content Provider | Scilit |
|---|---|
| Author | Moschetta, Marco Telegrafo, Michele Carluccio, Davide Antonio Rella, Leonarda Ianora, Amato Antonio Stabile Angelelli, Giuseppe |
| Copyright Year | 2016 |
| Abstract | Purpose: To evaluate the role of multidetector computed tomography (MDCT) in recognizing the complications of extracorporeal shock wave lithotripsy (ESWL) and providing a prognostic grading system for the therapeutic approach. Materials and Methods: A total of 43 patients who underwent ESWL because of urinary stone disease were assessed by 320-row MDCT examination before and after ESWL. Pre-ESWL CT unenhanced scans were performed for diagnosing stone disease. Post-ESWL CT scans were acquired before and after intravenous injection of contrast medium searching for peri-renal fluid collection or hyper-density, pyelic or ureteral wall thickening, blood clots in the urinary tract, peri- or intra-renal hematoma or abscess, active bleeding. A severity grading system of ESWL complications was established. Results: Patients were affected by renal (n = 36) or ureteral (n = 7) lithiasis. Post-ESWL CT examination detected small fluid collections and hyper-density of peri-renal fat tissue in 35/43 patients (81%), pyelic or ureteral wall thickening in 2/43 (4%), blood clots in the urinary tract in 9/43 (21%), renal abscesses or hematomas with a diameter of <2 cm in 10/43 (23%), large retroperitoneal collections in 3/43 (7%), active bleeding from renal vessels in 1/43 (2%). Mild complications were found in 30 cases; moderate in 9; severe in 4. The therapeutic choice was represented by clinical follow-up (n = 20), clinical and CT follow-up (n = 10), ureteral stenting (n = 9), drainage of large retroperitoneal collections (n = 3), and arterial embolization (n = 1). Conclusion: MDCT plays a crucial role in the diagnosis of urolithiasis and follow-up of patients treated with ESWL recognizing its complications and providing therapeutic and prognostic indications. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839233/pdf |
| Ending Page | 172 |
| Page Count | 5 |
| Starting Page | 168 |
| File Format | XHTML |
| ISSN | 09747796 |
| e-ISSN | 09747834 |
| DOI | 10.4103/0974-7796.163792 |
| Journal | Urology Annals |
| Issue Number | 2 |
| Volume Number | 8 |
| Language | English |
| Publisher | Medknow |
| Publisher Date | 2016-01-01 |
| Access Restriction | Open |
| Subject Keyword | Complications Computed Tomography Extracorporeal Shock Wave Lithotripsy Urolithiasis Urology Annals, Volume 8, Issue 2 |
| Content Type | Text |
| Resource Type | Article |
| Subject | Urology |
