A 9‐year experience of renal injury at an Australian level 1 trauma centre

Abstract

Objective• To detail the 9-year experience of renal trauma at a modern Level 1 trauma centre and report on patterns of injury, management and complications. Patients and methods• We analysed 338 patients with renal injuries who presented to our institution over a 9-year period.• Data on demographics, clinical presentation, management and complications were recorded. Results• Males comprised 74.9% of patients with renal injuries and the highest incidence was amongst those aged 20-24 years.• Blunt injuries comprised 96.2% (n = 325) of all the renal injuries, with road trauma being the predominant mechanism accounting for 72.5% of injuries.• The distribution of injury grade was; 21.6% grade 1 (n = 73), 24.3% grade 2 (n = 82), 24.9% grade 3 (n = 84), 16.6% grade 4 (n = 56), and 12.7% grade 5 (n = 43).• Conservative management was successful in all grade 1 and 2 renal injuries, and 94.9%, 90.7% and 35.1% of grade 3, 4 and 5 injuries respectively. • All but one of the 13 patients with penetrating injuries were successfully managed conservatively. Conclusions• Road trauma is the greatest cause of renal injury.• Most haemodynamically stable patients are successfully managed conservatively.

Is Accompanying Organ Damage Related with Mortality in Renal Trauma?

“…Lanchon et al (16) reported the success rate of conservative treatment in patients with grade 4 and 5 renal traumas as 88% and 50%, respectively. In a study by Shoobridge et al (19), all patients with grade 1-2 injury, 94% of the patients with grade 3 injury, 90% of the patients with grade 4 injury, and 35% of the patients with grade 5 injury were followed conservatively. In a retrospective study by Ekşi et al conducted with 135 renal trauma cases, 86% of the patients were followed with conservative treatment, and exploration was performed for 18 patients.…”

Management of Renal Trauma a Ret R Ospective Study - Our Experience

“…[1][2][3] There has been a paradigm shift towards conservative management for severe blunt trauma. [1,[4][5][6][7][8][9] Successful management of renal injury depends upon accurate assessment of their extent. With the advancement in radiologic imaging modalities and the ready availability of computed tomography allows surgeon to be much more informed about the injuries that they are treating.…”

Blunt abdominal trauma. Kidneys injury. Part 3

“…Вместе с тем в ретроспективном исследовании из Южно-Африканской Республики [65] представлены 174 пострадавших, в том числе огнестрельное ранение было у 87 (50%), колото-ре-заное -у 43 (25%), закрытая травма -у 44 (25%). Распределение механизмов травмы различается у городского и сельского населения, однако дорож-но-транспортные происшествия устойчиво зани-мают первое место среди причин закрытой травмы с примерной частотой 70% [91,101]. Падение с вы-соты находится на втором месте -около 30% [23,36].…”

“…КT с КУ у гемодинамически стабильных паци-ентов является «золотым стандартом» диагностики травмы почек [53,76,83,89,91,99]. При правиль-ном выполнении она позволяет диагностировать все повреждения сосудов, паренхимы и собирательной системы почек, а также лоханочно-мочеточниково-го сегмента [19].…”

“…Shoobridge и соавт. [91] обнаружили, что кон-сервативная терапия была успешной у всех постра-давших с травмой почки I и II степени, у 94,9, 90,7 и 35,1% пациентов с травмой III, IV и V степени соот-ветственно.…”