Timing and Predictors for Urinary Drainage in Children with Expectantly Managed Grade IV Renal Trauma

Reese, Jeremy; Fox, Janelle; Cannon, Glenn M.; Ost, Michael C.

doi:10.1016/j.juro.2014.02.039

Cited by 30 publications

(10 citation statements)

References 18 publications

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“…In all, 18 children (12 boys, six girls) with mean (range) age 11 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) years were included. According to the AAST grading criteria, 39% (seven of 18) of the patients had grade III, 50% (nine of 18) grade IV, and 11% (two of 18) grade V injuries; 44% (eight of 18) had concomitant injuries.…”

Section: Resultsmentioning

confidence: 99%

“…None of our patients had percutaneous drainage. Reese et al investigated the timing and predictors for urinary drainage in children with conservatively managed AAST grade IV renal injury. The mean time to intervention here was 11 days and the main predictors for urinary drainage were (i) collecting system haematoma(s) and (ii) large urinoma size (mean largest dimension 4.29 cm).…”

Section: Discussionmentioning

confidence: 99%

“…Pseudoaneurysm and AV fistulae are often the cause of a significant secondary bleed . However, these sequelae are more commonly associated with penetrating stab injuries to the kidney rather than blunt trauma . In a recent literature review by Yamacake et al , 38 reported cases of renal artery pseudoaneurysm following blunt renal trauma were identified, of which only four were paediatric cases.…”

Section: Discussionmentioning

confidence: 99%

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Management of paediatric high‐grade blunt renal trauma: a 10‐year single‐centre UK experience

et al. 2018

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of paediatric high‐grade blunt renal trauma: a 10‐year single‐centre UK experience

et al. 2018

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“…Continuous monitoring and serial imaging studies are performed because of the presence of extensive hematoma, renal dissociated fragments, interpolate contrast extravasation>=4cm urinoma and intense pain or fever are associated with conservative treatment fails and surgery. [8][9][10] Surgical exploration is not indicated from the beginning since this entails a higher index of nephrectomy. 10 The congenital abnormalities and tumors have a higher incidence in patients with abdominal trauma in pediatric age, with an incidence of up to 12.6%.…”

Section: Discussionmentioning

confidence: 99%

Wilms Tumor Rupture after Minimal Renal Trauma, Case Report

Andrade¹

2015

MOJCR

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Background: Wilms tumor diagnosis due to minimal abdominal trauma is rare and represents a diagnostic and therapeutic challenge. Introduction: A 3-year-old girl presented with one week history of slight left flank pain after fell down from her own height, associated with nausea and vomiting. Physical examination showed abdominal bloating and severe left flank pain. The CT scan showed kidney grade III injury and an upper pole solid mass of 12.8x9x7 cm and 68 UH. Nephrectomy was performed. Histopathology reported a Wilms tumor of 13x8x6cm with Gerota fascia rupture. Nine months later she came back with pulmonary and peritoneal metastases. Conclusion: Renal trauma is more common in children due to anatomical abnormalities and any discrepancy between the mechanism of injury and physical examination should be suspected for congenital or pathological issues.

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“…2 80-90% of renal injury is caused by blunt injury. 3 Children, compared to adults, have at a higher risk of renal injury from blunt trauma due to a variety of anatomic factors including decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. While there are strong trends toward non-operative management of blunt renal trauma, there are no explicit guidelines for high grade injuries.…”

Section: Full Text Introductionmentioning

confidence: 99%

Pediatric Blunt Renal Trauma. A Single Institution’s 20 Years Experience with Surgically Treated Patients.

Karavdić

2020

AJTES

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Background: Kidney is the most common site of genitourinary trauma. 50% of all urinary injuries is kidney.Kidney is also affected in 8-12% of all blunt and penetrating trauma to abdomen. 80-90% of renal injury is caused by blunt injury GY. Children, compared to adults, have at a higher risk of renal injury from blunt trauma due to a variety of anatomic factors including decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. While there are strong trends toward non-operative management of blunt renal trauma, there are no explicit guidelines for high grade injuries. Organ preservation in children is always a primary goal with solid organ injury. Aim of the work: The aim of the retrospective study is to show the specificity of kidney injury in children as well as the specificity of surgical treatment. Material and Methods: All 19 patients under the age of 18 who were admitted to Clinic for Pediatic surgery in Sarajevo with a diagnosis of renal trauma were retrospectively reviewed .The Echo an CT were used to identify patients with a renal injury. The time period examined was between January 1, 1999- 2019. Inclusion criteria were either a diagnosis of renal trauma or a diagnosis of blunt abdominal trauma and hematuria. Exclusion criterion was death due to an additional traumatic injury. The mechanism of injury (fall, car accident , assault) injury grade (I-V), the presence of hematuria, and demographic data to include age, weight, and sex, were recorded and reviewed. In addition, amount of blood product required, hematocrit nadir prior to transfusion to assist in ascertaining whether transfusion was necessary, surgical interventions performed, and hospital length of stay were also retrospectively analyzed. Due to the low sample size we used descriptive as opposed to inferential statistics in our analysis. Result: Demographics include male to female ratio of 13:6 and the average age of patients was 11.9 + 4.6 years. Of the nineteen patients who underwent review, eleven (57,89%) children presented with a grade III renal injury, five with a grade IV injury and three with grade V injury. Six patients presented with gross hematuria and 3 with microscopic hematuria. Only four patients (22%) required blood transfusions, with the average hematocrit nadir being 31 + 5.3% (24.8-37.8). One of the two patients transfused had a concomitant grade IV splenic laceration with a hematocrit nadir of 24.8% and clinical symptoms consistent with shock. Conclusions:The specificity of the child's anatomy is an aggravating prognostic factor (the kidney is larger in relation to the body cavity than in adults, less protected against the ribs, the muscles of the body and the lower abdomen, the less developed peritoneal and retroperitoneal fatty tissue).It is recommended to initiate conservative treatment (leaching, infusion solution, monitoring) and possibly delayed surgical treatment.Indications for early surgicaly treatment are reserved only for patients with bleeding (absolute) and extravasation (relative).If it is necessary surgical treatment sould be maximally preserve kidney tissue.

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Timing and Predictors for Urinary Drainage in Children with Expectantly Managed Grade IV Renal Trauma

Cited by 30 publications

References 18 publications

Management of paediatric high‐grade blunt renal trauma: a 10‐year single‐centre UK experience

Management of paediatric high‐grade blunt renal trauma: a 10‐year single‐centre UK experience

Wilms Tumor Rupture after Minimal Renal Trauma, Case Report

Pediatric Blunt Renal Trauma. A Single Institution’s 20 Years Experience with Surgically Treated Patients.

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