Complications of extracorporeal shock-wave lithotripsy are rare, with
an incidence of symptomatic perinephric hematoma ranging from 0.2% to
0.66%. A 59-year-old man had massive symptomatic retroperitoneal and i
ntra-abdominal bleeding 24 hours after lithotripsy. The hemorrhage was
managed successfully by conservative measures, which consisted of pac
ked red blood cells and fresh frozen plasma. The literature on the ble
eding complications of lithotripsy is reviewed and the risk factors ar
e identified.