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A rare complication of ESWL: Focal metastatic multiple organ abscesses in a horseshoe kidney

Ugur Kuyumcuoglu, Bilal Eryildirim, Murat Tuncer, Gokhan Faydaci, Tevfik Aktoz, Hakan Akdere, Kemal Sarıca
  • Ugur Kuyumcuoglu
    Trakya University, Faculty of Medicine, Urology Clinic, Edirne, Turkey
  • Bilal Eryildirim
    Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey
  • Gokhan Faydaci
    Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey
  • Tevfik Aktoz
    Trakya University, Faculty of Medicine, Urology Clinic, Edirne, Turkey
  • Hakan Akdere
    Trakya University, Faculty of Medicine, Urology Clinic, Edirne, Turkey
  • Kemal Sarıca
    Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey

Abstract

Extracorporeal shock wave lithotripsy (ESWL) is an effective treatment modality in the minimal invasive management of urinary system stone disease. Although the majority of the complications occuring after ESWL are minor (most common ones are gross haematuria, pain, perinephritic hematoma); bacteriuria may also occur in some cases which sometimes can lead to sepsis and even metastatic abscess formation in a very rare part of the cases treated. In this rare situation infection agent spreads quickly via hematogenous route and causes abscess formation in different parts of the body. Majority of such cases usually have an underlying systemic disease like diabetes mellitus (DM), malignancy, HIV or steroid use which lead to disruption of immune system functions. Abscess formation following ESWL is extremely rare and usually limited with some case reports published in the literature. Herein, we present a diabetic case with formation of multiple abscess foci in kidney, as well as in lungs and liver following ESWL. The patient was first admitted to our emergency department with high fever and respiratory distress and misdiagnosed as metastatic tumor foci based on radiologic findings. To the best of our knowledge, our case is the first one in the literature in whom simultanous abscess formation in multiple organ systems has been documented following an otherwise uneventful ESWL.

Keywords

ESWL (Extracorporeal Shockwave Lithotripsy); Abscess; Complications

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Submitted: 2014-07-09 17:36:56
Published: 2014-06-30 00:00:00
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Copyright (c) 2014 Ugur Kuyumcuoglu, Bilal Eryildirim, Murat Tuncer, Gokhan Faydaci, Tevfik Aktoz, Hakan Akdere, Kemal Sarıca

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