Contemporary management of acute kidney trauma

Costa, Inês Anselmo da; Amend, Bastian; Stenzl, Arnulf; Bedke, Jens

doi:10.1016/j.joad.2015.08.003

Cited by 12 publications

(6 citation statements)

References 32 publications

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“…We found renal trauma to be present in around 1% of patients admitted for trauma and 13% of patients with abdominal trauma in this Indian cohort. This is comparable to global trauma literature with renal trauma present in around 0.5-5% of patients admitted for trauma and 8-20% of patients with abdominal trauma [4,6,7,18].…”

Section: Discussionsupporting

confidence: 82%

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Outcomes of Renal Trauma in Indian Urban Tertiary Healthcare Centres: A Multicentre Cohort Study

et al. 2021

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Background Renal trauma is present in 0.5–5% of patients admitted for trauma. Advancements in radiologic imaging and minimal-invasive techniques have led to decreased need for surgical intervention. We used a large trauma cohort to characterise renal trauma patients, their management and outcomes. Methods We analysed “Towards Improved Trauma Care Outcomes in India” cohort from four urban tertiary public hospitals in India between 1st September 2013 and 31st December 2015. The data of patients with renal trauma were extracted using International Classification of Diseases 10 codes and analysed for demographic and clinical details. Results A total of 16,047 trauma patients were included in this cohort. Abdominal trauma comprised 1119 (7%) cases, of which 144 (13%) had renal trauma. Renal trauma was present in 1% of all the patients admitted for trauma. The mean age was 28 years (SD-14.7). A total of 119 (83%) patients were male. Majority (93%) were due to blunt injuries. Road traffic injuries were the most common mechanism (53%) followed by falls (29%). Most renal injuries (89%) were associated with other organ injuries. Seven of the 144 (5%) patients required nephrectomy. Three patients had grade V trauma; all underwent nephrectomy. The 30-day in-hospital mortality, in patients with renal trauma, was 17% (24/144). Conclusion Most renal trauma patients were managed nonoperatively. 89% of patients with renal trauma had concomitant injuries. The renal trauma profile from this large cohort may be generalisable to urban contexts in India and other low- and middle-income countries.

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Section: Discussionsupporting

confidence: 82%

“…The median ISS was 17 (IQR-9-21). Patients with grade IV and V renal trauma had predominantly severe (16)(17)(18)(19)(20)(21)(22)(23)(24)(25) and profound (26-75) ISS. However, the ISS in these patients did not correlate with the need for surgical intervention.…”

Section: Resultsmentioning

confidence: 99%

Outcomes of Renal Trauma in Indian Urban Tertiary Healthcare Centres: A Multicentre Cohort Study

et al. 2021

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“…Retention of a shattered kidney also can predispose a patient to urinary leaks or urinoma, increasing the risk for sepsis. In general, urinary leaks should be repaired with stents or diverted appropriately with drains provided by IR and Urology [ 14 ]. Delayed recognition and control of these complications can worsen sepsis.…”

Section: Discussionmentioning

confidence: 99%

Role of Emergent Nephrectomy for Grade V Blunt Renal Injuries

et al. 2021

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Case series Patients: Male, 18-year-old • Female, 21-year-old Final Diagnosis: Grade V renal laceration Symptoms: Abdominal pain • flank pain Medication: — Clinical Procedure: Nephrectomy Specialty: Surgery Objective: Unusual clinical course Background: Blunt renal injuries constitute a small proportion of solid organ trauma cases. Many American Association for the Surgery of Trauma grade IV and V lacerations are manageable with volume resuscitation and angioembolization. In select cases, emergent nephrectomy can be beneficial to patients, with little associated morbidity. Case Reports: In 2 separate cases, an 18-year-old man and a 21-year-old woman were brought to our center after sustaining blunt trauma to the left flank. They were both found to have isolated grade V renal lacerations with vascular compromise. Both initially had normal vital signs but became unstable. Active extravasation was visible on contrast-enhanced computed tomography scans, and the patients ultimately underwent exploratory laparotomy and nephrectomy on hospital day 1. Both of them recovered quickly, had no acute complications, and were discharged in <1 week. Follow-up over the course of 1 year showed no untoward sequelae. Conclusions: These cases highlight the role of nephrectomy to mitigate life-threatening hemorrhage in unstable patients. While observation or angioembolization is the preferred approach for many renal injuries, emergent nephrectomy remains important for patients who do not respond to blood products and have rapidly deteriorating shock. In these patients, results of an initial trauma evaluation can be unclear because of concomitant splenic injury, as well as renal injuries with hemoperitoneum that are visible on focused abdominal ultrasonography for trauma. When forgoing immediate laparotomy, surgeons can use continuous noninvasive hemoglobin monitoring along with serial hemoglobin measurements and abdominal examinations. Laparotomy with nephrectomy results in limited morbidity when it is done expeditiously with ongoing volume resuscitation.

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“…Penatalaksanaan pada pasien trauma tumpul pada saat di IGD yaitu berfokus yaitu memerlukan penilaian dan sistem perawatan yang cepat dan terorganisir. Manajemen awal pasien dilakukan survei primer, yang bertujuan untuk mengidentifikasi dan mengobati cedera yang membahayakan nyawa pasien dan survei sekunder, yang berupaya untuk mendeteksi semua cedera serta memulai perawatan definitif (Amend, B., Stenzl, A., & Bedke, J., 2016).…”

Section: Metodeunclassified

“…Memeriksa kontusio, abrasi, laserasi, deformitas, perubahan warna, edema, benda asing dan kelainan lainnya. Mengkaji semua area tubuh untuk menemukan area nyeri, krepitus, deformitas, kehilangan fungsi dan lokasi serta kualitas denyut nadi (Amend, B., Stenzl, A., & Bedke, J., 2016).…”

Section: Metodeunclassified

Analisis Seri Kasus Pseudoaneurysm Setelah Trauma Ginjal Tumpul pada Tahun 2016-2020

Kumalasari

Sudaryanto

2020

jiskh

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Pendahuluan: Trauma ginjal terjadi sekitar 1-5% dari kejadian seluruh trauma dan sekitar 10% pasien mengalami tarauma abdomen. Pseudoaneurysm merupakan komplikasi vaskular yang jarang terjadi setelah trauma tumpul. Tujuan dari penulisan ini ingin menganalisis kasus-kasus pseudoaneurysm setelah trauma ginjal tumpul. Metode: Desain yang digunakan dalam study literature ini menggunakan desain literature review. Analisis yang digunakan penulis yaitu analisis narrative review. Pencarian artikel menggunakan PubMed dan Google Scholar sesuai tema yang dipilih kemudian dilakukan review. Hasil: Dari 5 artikel yang mengalami pseudoaneurysm setelah trauma tumpul ginjal diderita terbanyak pada laki-laki. Empat kasus disebabkan karena jatuh. Tanda dan gejala dari lima kasus yaitu penurunan kadar hemoglobin darah dan gross hematuria. Empat kasus mengalami trauma ginjal tumpul dibagian kanan dan hasil CT Scan menunjukkan 3 kasus pada derajat III. Diskusi: Pada kalangan dewasa yang sering ditemukan yaitu laki-laki saat usia produktif. Umur seseorang menjadi faktor resiko terjadinya pseudoaneurysm setelah trauma tumpul ginjal. Pemeriksaan hematokrit disertai dengan pemeriksaan hemoglobin darah berperan untuk mengetahui tanda perdarahan aktif yang dicurigai adanya penurunan kadar hemoglobin. Kesimpulan: Analisis dari ke lima artikel didapatkan adanya tanda gross hematuria dan penurunan kadar hemoglobin darah serta tindakan medis yang sering digunakan yaitu embolisasi. Kata Kunci: Pseudoaneurysm, Ginjal, Trauma Tumpul, Embolisasi, Analisis

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Contemporary management of acute kidney trauma

Cited by 12 publications

References 32 publications

Outcomes of Renal Trauma in Indian Urban Tertiary Healthcare Centres: A Multicentre Cohort Study

Outcomes of Renal Trauma in Indian Urban Tertiary Healthcare Centres: A Multicentre Cohort Study

Role of Emergent Nephrectomy for Grade V Blunt Renal Injuries

Analisis Seri Kasus Pseudoaneurysm Setelah Trauma Ginjal Tumpul pada Tahun 2016-2020

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