The Higher Injury Risk of Abnormal Kidneys in Blunt Renal Trauma

Schmidlin, R; Khan, Hamza Abdur Rahim; Farshad, M.; Niederer, Peter F.; Iselin, Christophe

doi:10.1097/00005392-199904010-00060

Cited by 25 publications

(45 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Schmidlin et al (8) found an incidence of 19% of abnormal kidneys in their series of blunt renal trauma. Chaparro et al (12) reported 11.6% of abnormal Renal Tumor and Trauma kidneys associated with trauma.…”

Section: Discussionmentioning

confidence: 95%

Renal tumor and trauma: a pitfall for conversative management

et al. 2011

View full text Add to dashboard Cite

Purpose: Conservative management has been largely used for renal trauma. Although this approach is safe and highly recommended, it can hide a pre-existing unknown condition, such as tumors or urinary malformations. A high index of suspicion is needed for early recognition of these conditions. We present four cases treated at the Pediatric Oncology Institute -Federal University of São Paulo, which have been initially treated conservatively for renal trauma. Materials and Methods:We reviewed all 218 renal cases of renal tumors treated at our institution in a 22-year period, searching for associated trauma events. Results: Four cases of renal tumors were initially treated conservatively for blunt renal trauma of low energy mechanism. Patients' ages ranged from 7 to 12 years old. Two patients had no previous symptoms, one patient had hematuria and another had an abdominal mass. Computerized Axial Tomography (CT) of the abdomen revealed disparate magnitude of the renal bleeding to the low energy mechanism of trauma. All patients underwent surgical treatment. Kidney specimens showed Wilms tumor in three cases and renal carcinoma in one. Conclusions:The association between renal tumors and trauma should be suspected when renal trauma hemorrhage on abdominal CT scan does not match the low energy mechanism of blunt abdominal trauma. The key for a successful diagnosis of renal tumor or congenital malformations is the high index of suspicion for these conditions.

show abstract

Section: Discussionmentioning

confidence: 95%

Renal tumor and trauma: a pitfall for conversative management

et al. 2011

View full text Add to dashboard Cite

show abstract

“…An abnormal kidney is also more likely to be injured, and pre-existing renal abnormalities (e.g. hydronephrosis, cyst, tumor) have been reported in up to 19% of adult blunt renal injuries [11] .…”

Section: Reviewmentioning

confidence: 99%

Renal Injury: 5-Year Experience and Literature Review

et al. 2006

View full text Add to dashboard Cite

Introduction: Appropriate management of renal trauma is controversial. The purpose of this study is to present our 5-year experience in renal trauma and review the literature. Materials and Methods: From 1999 to 2003, 28 patients were identified with renal injuries. 25 (89.3%) of the injuries were caused by blunt trauma, 2 (7.1%) by stab wounds, and 1 (3.6%) by gunshot wound. Methods for diagnosis included ultrasonography (US), computed tomography (CT), diagnostic peritoneal lavage (DPL), combinations of more than one technique or no one of them. The English-language literature about renal trauma was also identified using Medline, and additional cited works not detected in the initial search obtained. Results: 18 patients underwent immediate or during 24 h operation; while 5 nephrectomies were performed. 11 patients with grade I to III injuries were selected for nonoperative management of renal injuries. All complications were noted and studied according to the initial therapeutic management and grade. Follow-up was clinical and radiological. 3 postoperative deaths were observed. Conclusion: The goals of treatment of renal injuries include accurate staging and minimal complications. Surgery can be avoided in most cases of blunt renal injury but there is also a trend towards conservative management of penetrating trauma. Nephrectomy is associated with high-grade renal injuries, while minor renal injuries can safely be managed conservatively.

show abstract

“…The kidney parenchyma is surrounded by a thin, tough, fibrous capsule that is thought to protect the kidney from injury during blunt impact (Kleiman, 1958, Schmidlin et al, 1998. The renal capsule was modeled using membrane elements sharing nodes with the underlying parenchymal elements on the surface of the kidney.…”

Section: Finite Element Model Of Pneumatic Gun Impactsmentioning

confidence: 99%