Severe perinephric hemorrhage after shockwave lithotripsy.

We report a case of a 69-year-old man who, after a second session of shockwave lithotripsy for multiple stones in the right kidney, showed symptoms of severe hemorrhage and flank pain unresponsive to analgesics, with the gradual development of extensive and serious perinephric hematoma. The bleeding necessitated nephrectomy. Unrecognized chronic pyelonephritis may have been a predisposing factor.