Case report of bilateral penetrating renal trauma caused by a wooden stick

Abstract

Rationale: Kidney is the most frequently injured organ of the genitourinary system during trauma. Bilateral penetrating renal trauma (BPRT) is extremely rare and sporadically reported in the previous literature. Here, we reported a unique case of BPRT.Patient concerns: A 43-year-old man, with no medical history, was accidentally penetrated by a wooden stick and presented with sharp pain in the left flank.Diagnosis: Laboratory tests revealed microscopic hematuria, mildly elevated leucocyte and amylase, normal hemoglobin (145 g/L) and creatinine (1.05 mg/dl). Computed tomography demonstrated bilateral penetrating renal injuries with perinephric/subcapsular hematoma, fracture of the second lumbar vertebra and 10th rib.Interventions: An emergency exploratory laparotomy was executed immediately. According to the American Association for the Surgery of Trauma Organ Injury Scale grading system, grade V and III injuries were considered for the left and right kidney, respectively. Nephrectomy and renorrhaphy were performed on the left and right kidney, respectively.Outcomes: The postoperative course was uneventful. Eleven days after the surgery, the patient discharged with no complications.Lessons: We present a rare and challenging case which was handled successfully, and it may provide useful information for the management of BPRT.

Renorrhaphy of Unilateral Grade V Blunt Renal Injury: Case Report

“…The examination identified 31 (62%) patients with severe hematuria, 12 (24%) patients with microscopic hematuria, and 7 (14%) patients without hematuria. 7 In our case, only gross hematuria was seen, along with pain in the left flank area. The gold standard of imaging for hemodynamically stable patients with blunt renal injury is now intravenous contrast-medium enhanced CT to assess the injury, rule out substantial extravasation, and rule out potentially treatable related injuries.…”

“…Our patient reported a VAS score of 6/10 across the left flank area, which was confirmed by a contrast CT scan as renal injury. 7 Hematuria and hypotension are two critical clinical signs that indicate an increased risk of severe renal impairment. Urinalysis provides rapid information in patients suspected of having sustained renal parenchymal lacerations.…”

“…The gold standard of imaging for hemodynamically stable patients with blunt renal injury is now intravenous contrast-medium enhanced CT to assess the injury, rule out substantial extravasation, and rule out potentially treatable related injuries. 7 We do a CT scan immediately to confirm the diagnosis of renal trauma.…”

“…Conservative therapy, minimally invasive intervention, and open surgery are all treatment possibilities of renal trauma. 7 Conservative treatment usually entails bed rest, analgesics, hemodynamic monitoring, serial laboratory assessment, and reimaging if the condition worsens.…”

Nail Gun Penetrating Renal Injury: A Case Report

“…The most frequently reported type of renal injury is blunt trauma, accounting for 71%-95% of all cases of renal injuries. Though penetrating renal injuries are less common, they are often associated with a less favorable prognosis and a higher risk of more serious interventions, such as a nephrectomy [ 1 , 2 ]. The mechanism through which penetrating renal injuries occur varies considerably, resulting in different grades of injury which may affect the management decision.…”