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60歳,男性.右腎結石に対して,シーメンス社Lithostarを用い体外衝撃波砕石術を行った.施行後20時間目より上腹部痛が出現,超音波検査,CTにて肝左葉の損傷と腹腔内出血を認めた.理論上,肝左葉への衝撃波の影響は考え難いが,今回の症例は肝破裂を起こすような基礎疾患が術前に認められなかったことより,体外衝撃波砕石術が肝破裂の原因として考えられた.
A 60-year-old man underwent ESWL for right renal caluculus, using Siemens' Lithostar. Epigastralgia appeared 20 hours thereafter. Ultrasonography and CT revealed left hepatic lobar injury and intraperitoneal bleeding. Shock wave is recognized to have some influence on parenchymal organs as well, but the liver repture of this case is very difficult to be specified in view of the fact that no underlying disease responsible for the liver rupture was recognized preoperatively and left hepatic lobe was theoretically free from the influence of shock wave. However, we cannot but presume that liver ruptor was caused by ESWL.
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