논문 상세보기
pp.82-86
48세 여자가 좌측 옆구리 통증을 주소로 내원하여 좌측 요관 결석으로 진단되어 체외 충격파쇄석술을 시행받았으나, 12시간 후 갑작스런 복통을 호소하며 혈압저하, 폐부종을 보였다. 국소적인 합병증을 동반한 중등도의 급성 췌장염으로 진단하고 수액과 승압제, 항생제 등의 대증적 치료 시행 후 퇴원하였다. 체외 충격파쇄석술은 요로결석의 대표적인 치료법이다. 안전하고 효과적으로 알려져 있으나 시술받은 환자의 1%에서 급성 췌장염, 신장주위 혈종, 비뇨기계 패혈증, 정맥혈전, 담도 폐쇄, 장천공, 폐손상, 부정맥 등의 심각한 합병증이 보고되고 있다. 쇄석술 이후 발생한 급성 췌장염은 드물지만 임상의는 이러한 합병증에 대한 주의가 필요하다.
48-year-old woman was admitted to emergency room due to left flank pain. It was diagnosed with left ureteral stone and underwent extracorporeal shock wave lithotripsy (ESWL). However, 12 hours later, the patient complained acute upper abdominal pain with pulmonary edema and low blood pressure. A diagnosis of moderate acute pancreatitis with local complication was considered and we decided conservative therapy including fluid resuscitation, inotropics and antibiotics. It was suggested that ESWL was responsible for the acute pancreatitis. The patient gradually recovered and was discharged on 13th day of admission. ESWL is considered the standard treatment for urolithiasis. Although, it has proved to be safe and effective, serious complications have been reported in 1% of patients, including acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, and cardiac arrhythmia. Although the possibility of post-ESWL acute pancreatitis is extremely low, physicians should take care of this complication.
