Septic shock following flexible transurethral lithotripsy showing favorable response after multidisciplinary treatment mainly composed of acute blood purification therapy：A case report

Abstract

We present a case of a 62-year-old woman who developed severe septic shock following flexible transurethral lithotripsy (f-TUL), showing favorable response after multidisciplinary treatment consisting mainly of acute blood purification therapy. The patient underwent f-TUL for nephrolithiasis of the right kidney. The operation was completed with no specific intraoperative complications. Blood pressure decreased and clouding of the consciousness as observed the day after the operation. Hematological examination showed high-level acute inflammatory reaction and lower platelet counts, indicative of severe septic shock and disseminated intravascular coagulation (DIC). The patient was transferred immediately to the intensive care unit (ICU). Multidisciplinary treatment comprising continuous hemodiafiltration (CHDF) and endotoxin adsorption therapy (PMX) was administered. The treatment was successful. The patient recovered from DIC at an early stage and left the hospital at 34 days after the operation. Risk of complication is expected to increase with the spread of f-TUL. Prompt action including acute blood purification therapy must be taken.