567 INTERVENTIONAL STRESS IN RENAL STONE TREATMENT: A COMPARISON BETWEEN EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY, URETERORENOSCOPY AND MINIMALLY INVASIVE PERCUTANEOUS NEPHROLITHOLAPAXY BY MEASUREMENT OF INTERLEUKINE-6 AND C REACTIVE PROTEIN

Background: Extracorporeal shockwave lithotripsy (ESWL) has proved to be effective in treating ureterolithiasis. This study aimed to investigate the predictive factors related to success ESWL among patient presented with renal stone. Methods: A retrospective study was conducted among 40 patients who underwent ESWL at the urology department, Baquba Teaching Hospital, Diyala University, Iraq. Data was collected between1st October 2018 and 31st January 2019 for renal stones diagnosed by non-enhanced spiral computed tomography (NCCT). The success rate defined as no stone or the remnant stones < 4 mm. We analyzed predictive factors by using multiple linear regression. Results: The success rates ranged from 50-90%. In the univariate analysis, body mass index (BMI), skin-to-stone distance (SSD)and the renal stone-attenuation value (in Hounsfield units, HU) were found to be significantly correlated with the outcome of ESWL (p<0.05). However, in the multiple linear regression, only the HU (B = -0.619, P < 0.0001; 95% confidence interval [CI]:0.03 to 0.07) was theindependent predictive factor. Conclusion: Hounsfield Unit is an independent predictive factor influencing the success of ESWL for treating renal stones.

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940 Mesenteric Haematoma Complicated by A Perforated Sigmoid Diverticulum Following Extracorporeal Shockwave Lithotripsy

British Journal of Surgery ◽

10.1093/bjs/znab134.181 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

P Sorooshian ◽

A Luangsomboon ◽

B Al-Robaie

Keyword(s):

Abdominal Pain ◽

Renal Stone ◽

Rare Complication ◽

Lower Abdominal Pain ◽

Sudden Onset ◽

Extracorporeal Shockwave Lithotripsy ◽

Shockwave Lithotripsy ◽

Extracorporeal Shockwave ◽

End Colostomy ◽

Left Hemi

Abstract A 78 year old female presented with sudden onset lower abdominal pain, vomiting and fresh rectal bleeding. She had undergone extracorporeal shockwave lithotripsy (ECSL) for a left renal stone two weeks earlier and was taking Rivaroxaban for atrial fibrillation. A CT Abdomen & Pelvis revealed a large mesenteric haematoma and a contained sigmoid perforation secondary to compressive forces of the haematoma on the sigmoid artery, resulting in ischaemia. While mesenteric angiogram-guided embolisation initially controlled the active sigmoid artery bleed, the patient clinically deteriorated the following day warranting a laparotomy. This revealed an ischaemic sigmoid colon with contained faeculent material within the mesentery. An extended left hemi-colectomy with end-colostomy was performed. Despite optimal critical care input, the patient developed multi-organ failure and passed away one week later. Mesenteric haematoma should be considered as a rare complication in patients with sudden onset abdominal pain following ECSL; especially with concurrent anti-coagulation use.

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