Lithotripsy-induced splenic injury requiring emergent splenectomy at a level 1 trauma center

Splenic injury is an exceedingly rare, potentially life-threatening complication of ESWL. We feature the 4th report since 2020 and 14th overall since practice inception in 1980. Despite the resources of a large level 1 trauma center, our case highlights non-operative management may not be pragmatic in the emergent circumstance. Patient and provider education and early recognition remain key to optimize outcomes.