Blunt renal trauma in children: a retrospective analysis of 41 cases

Balcıoğlu, Mehmet Emin; Böleken, Mehmet Emin; Cevik, Muazez; Savaş, Murat; Boyacı, Fatıma Nurefşan

doi:10.5505/tjtes.2014.65392

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…The majority of children with blunt renal trauma can be managed conservatively even with high-grade injuries. [ 13 14 15 16 17 18 ] Our study confirmed the previous findings of low pediatric nephrectomy rates (0%–3.2%). [ 7 17 19 20 ]…”

Section: Discussionsupporting

confidence: 90%

Characteristics and management of blunt renal injury in children

Ishida

Tyroch

Emami

et al. 2017

J Emerg Trauma Shock

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Background:Renal trauma in the pediatric population is predominately due to blunt mechanism of injury. Our purpose was to determine the associated injuries, features, incidence, management, and outcomes of kidney injuries resulting from blunt trauma in the pediatric population in a single level I trauma center.Methods:This was a retrospective chart and trauma registry review of all pediatric blunt renal injuries at a regional level I trauma center that provides care to injured adults and children. The inclusion dates were January 2001–June 2014.Results:Of 5790 pediatric blunt trauma admissions, 68 children sustained renal trauma (incidence: 1.2%). Only two had nephrectomies (2.9%). Five renal angiograms were performed, only one required angioembolization. Macroscopic hematuria rate was significantly higher in the high-grade injury group (47% vs. 16%; P = 0.031). Over half of the patients had other intra-abdominal injuries. The liver and spleen were the most frequently injured abdominal organs.Conclusion:Blunt renal trauma is uncommon in children and is typically of low American Association for the Surgery of Trauma injury grade. It is commonly associated with other intra-abdominal injuries, especially the liver and the spleen. The nephrectomy rate in pediatric trauma is lower compared to adult trauma. Most pediatric blunt renal injury can be managed conservatively by adult trauma surgeons.

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Section: Discussionsupporting

confidence: 90%

Characteristics and management of blunt renal injury in children

Ishida

Tyroch

Emami

et al. 2017

J Emerg Trauma Shock

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“…According to the literature, the prevalence of surgical therapy ranges from 8 to 31% and the prevalence of conservative treatment is from 70 to 92% 22 . Recent investigations have found that the surgery ratio is frequently low.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Blunt Abdominal Solid Organ Injury in Children: A Single Centre Study

Haq¹,

Rehman²,

Makki³

et al. 2023

PJMHS

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Aim: To determine the management of solid organ injuries in blunt trauma abdomen (BTA) in children whether to conserve or operate. Study design: Descriptive case series. Place and duration of study: Department of Paediatric Surgery Sahiwal Teaching Hospital and Sahiwal Medical College Sahiwal from 1st January 2020 to 31st March 2022. Methodology: Fifty eight patients with blunt abdominal trauma due to any cause, the medical records of all patients with trauma of any kind age upto 13 years were carefully reviewed. Initial resuscitation was done according to ATLS protocol. Ultimate management decision was based on stability of patients after resuscitation. Results: The mean age was 5.34 years. Most of the patients suffered from road traffic accident, 50(86.2%). Fifty two (89.65%) patients showed free fluid in the abdomen. Organ injury in 27(46.55%) patients. CT abdomen with intravenous contrast confirmed findings of ultra sonography. Despite resuscitation, 17(43.9%) patients remained unstable and were operated. Forty one patients were kept on conservative treatment. Hospital stay ranged from 1-19 days. Conclusion: Although non-operative management is the treatment of choice in blunt trauma abdomen with solid organ injury but stability of the injured child is the central pivot around which the whole management revolves. Delay in presentation and failure of timely resuscitation results into high operative intervention. Keywords: Blunt trauma, solid, Liver, Spleen, children

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“…Most of the blunt kidney injuries in children (85%) are low-grade. 1 Compared to adults, children have weaker abdominal muscles and less protective chest walls. In addition, their kidneys are moving, placed lower in the body, the ratio of kidney and body is large, and perirenal fat tissue is less.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, their kidneys are moving, placed lower in the body, the ratio of kidney and body is large, and perirenal fat tissue is less. [1][2][3] All these anatomical differences cause more kidney injuries in children with traumas compared to adults. Renal injuries detected via evaluation of patients physical examination, laboratory tests, and imaging methods in emergency department.…”

Section: Introductionmentioning

confidence: 99%

Renal traumas in childhood: a five years experience of tertiary care hospital in Turkey

et al. 2018

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Background: In this study, the experiences of kidney trauma of a third step hospital in a city at the junction of the road will be discussed with the current literature.Methods: Pediatric trauma patients admitted to Afyon Kocatepe University Hospital between 1 January 2012 and 31 December 2017 were retrospectively examined. Thirty patients with renal injuries were included in the study. Patients with renal injury were examined in terms of age, gender, type of trauma, degree of renal injury, additional organ damage, treatment method, duration of hospitalization, cost and mortality. Statistical analysis was performed with the SPSS program. The p >0.05 was considered as significant.Results: A total of 30 patients (m:23, f:7) were included in the study. The mean age of the patients was 12.10±5.70. The mean duration of hospitalization was 10.23±17.067 days. The reasons of kidney injury were determined as; traffic accident outside of the vehicle (n=9), fall (n=8), traffic accident inside the vehicle (n=6), bicycle-motorcycle accident (n=5), and firearm injury (n=2). Hematuria (n=8), grade 1 (n=12), grade 2 (n=2), grade 4 (n=5), and grade 5 (n=3) kidney injuries were detected in the patients. Isolated renal injuries were found in 7 patients. Additional organ injuries were found as lung injury (n=3), head injury (N=5), pelvic injury (n=5), spleen injury (n=8), spine injury (n=7), liver injury (n=7), intestinal injury (n=7), and extremity injury (n=7). The average cost was 4948.37 ± 10198.51 TL. One patient had nephrectomy and JJ catheter was placed to one patient due to the development of urinoma and hematoma. All other patients were treated conservatively. The cost and duration of hospitalization of patients with shock status at the time of admission to the hospital were statistically higher than those without shock status (p=0.001; p=0.025). Morbidity and cost of patients with high grades (grade 4 or 5) were higher than those with low grades (p=0.008 and p=0.027, respectively). There was no mortality except for a patient who underwent splenectomy and had concomitant brain parenchymal damage.Conclusions: Conservative treatment of kidney injuries for children is effective and safe. Additional injuries, shock status and high-grade cause morbidity, mortality and cost increases.

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Blunt renal trauma in children: a retrospective analysis of 41 cases

Cited by 5 publications

References 11 publications

Characteristics and management of blunt renal injury in children

Characteristics and management of blunt renal injury in children

Analysis of Blunt Abdominal Solid Organ Injury in Children: A Single Centre Study

Renal traumas in childhood: a five years experience of tertiary care hospital in Turkey

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