Common post lithotripsy complications include: abdominal pain, nausea and vomiting, ureteral colic, fever, and skin ecchymosis. Supportive therapy with IV fluids, analgesics, and antiemetics may be indicated. Check complete blood count, creatinine, urinalysis, and urine output; use antibiotics if appropriate. Severe flank pain, fall in hematocrit, hypotension, and syncope, can be caused by pernephric and renal hematomas. Diagnosis is by CT or US. Acute management may include IV fluids, blood transfusions, analgesics, and antibiotics. It is important to consult urology early in the process. Rare complications include injury to abdominal viscera and surrounding structures. Consult surgery and urology for these complications.