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Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report
Pneumatic lithotripsy is a minimally invasive technique mainly for the treatment of urinary staghorn stones. Previous literatures have reported some therapeutic complications during or after this procedure, but calculi embolism has not been mentioned before. We report here a fatal case of calculi-in...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554109/ https://www.ncbi.nlm.nih.gov/pubmed/26222867 http://dx.doi.org/10.1097/MD.0000000000001262 |
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author | Zhang, Lin Zhou, Yiwu |
author_facet | Zhang, Lin Zhou, Yiwu |
author_sort | Zhang, Lin |
collection | PubMed |
description | Pneumatic lithotripsy is a minimally invasive technique mainly for the treatment of urinary staghorn stones. Previous literatures have reported some therapeutic complications during or after this procedure, but calculi embolism has not been mentioned before. We report here a fatal case of calculi-induced pulmonary embolism in an adult woman who underwent pneumatic lithotripsy. An autopsy did not reveal any evidence of pulmonary embolism. However, light microscopy revealed noticeable presence of calculi in pulmonary arterioles and capillaries, as evidenced by environmental scanning electron microscope and energy dispersive X-ray analysis. The primary determinants of calculi embolism include intrarenal pressure, and volume and viscosity of the calculi fragments formation. Vascular intravasation of smashed calculi might increase pulmonary vascular resistance and hypoxemia and decrease cardiac output. This case report intends to provide information for clinicians to consider the probability of intraoperative calculi embolism during lithotripsies when patients develop typical symptoms of acute pulmonary embolism. |
format | Online Article Text |
id | pubmed-4554109 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-45541092015-10-27 Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report Zhang, Lin Zhou, Yiwu Medicine (Baltimore) 6700 Pneumatic lithotripsy is a minimally invasive technique mainly for the treatment of urinary staghorn stones. Previous literatures have reported some therapeutic complications during or after this procedure, but calculi embolism has not been mentioned before. We report here a fatal case of calculi-induced pulmonary embolism in an adult woman who underwent pneumatic lithotripsy. An autopsy did not reveal any evidence of pulmonary embolism. However, light microscopy revealed noticeable presence of calculi in pulmonary arterioles and capillaries, as evidenced by environmental scanning electron microscope and energy dispersive X-ray analysis. The primary determinants of calculi embolism include intrarenal pressure, and volume and viscosity of the calculi fragments formation. Vascular intravasation of smashed calculi might increase pulmonary vascular resistance and hypoxemia and decrease cardiac output. This case report intends to provide information for clinicians to consider the probability of intraoperative calculi embolism during lithotripsies when patients develop typical symptoms of acute pulmonary embolism. Wolters Kluwer Health 2015-07-31 /pmc/articles/PMC4554109/ /pubmed/26222867 http://dx.doi.org/10.1097/MD.0000000000001262 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 6700 Zhang, Lin Zhou, Yiwu Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report |
title | Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report |
title_full | Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report |
title_fullStr | Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report |
title_full_unstemmed | Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report |
title_short | Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy: A Case Report |
title_sort | massive pulmonary calculi embolism: a novel complication of pneumatic lithotripsy: a case report |
topic | 6700 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554109/ https://www.ncbi.nlm.nih.gov/pubmed/26222867 http://dx.doi.org/10.1097/MD.0000000000001262 |
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