Perforation of the small bowel during SWL is reported for the first ti
me, The patient was treated in the prone position for a ureteral stone
with 4500 shockwaves. There were no underlying or predisposing factor
s for the damage to the gut with the exception of the large number of
shockwaves at a high energy setting. It is concluded that SWL in the p
rone position with shockwaves traversing the peritoneal cavity carries
a risk of damage to the bowel, A reduction of the number of shockwave
s and the energy level should be considered in this setting.