Evaluation of renal traumas according to forensic radiology

African Journal of Urology, 2020

Background Renal trauma occurs in up to 5% of all trauma cases and accounts for 24% of abdominal solid organ injuries. Renal trauma management has evolved over the past decades, and current management is transitioning toward more conservative approaches for the majority of hemodynamically stable patients. The objective of this study was to analyze the mechanism of injury, management, and outcome in renal trauma. Methods Patients diagnosed with renal trauma in Makassar, Indonesia, from January 2014 to December 2018 were identified retrospectively by the ICD-10 code. Data were collected from medical records. Imaging was classified by radiologists. Variables analyzed included age, sex, mechanism of injury, degree of renal trauma, related organ injury, management, and outcome. Results Out of the 68 patients identified, the average age was 23.9 ± 0.6 years, and most were male (83.8%). Blunt trauma accounted for 89.7% of all cases. The most common renal injuries were grade IV (42.6%), and...

Case reports in urology, 2012

Introduction. Renal trauma patients are largely managed conservatively but on occasion have to be embolised or taken to theatre for definitive surgical management, usually in the form of emergency nephrectomy. Review. We present an overview of renal trauma as illustrated by three interesting cases of blunt renal trauma who presented in quick succession of each other to the Emergency Department. The first case-a 48-year-old-female passenger in a road traffic accident-was treated with life-saving emergency nephrectomy. The second patient-a 47-year-old man who sustained a high impact injury whilst sledging-was managed conservatively on HDU and subsequently on the urology ward. The third patient-an 18-year-old man involved in a road traffic accident-underwent selective embolisation of a pseudoaneurysm after conservative therapy. Discussion. This case series illustrates the surgical, radiological, and conservative approaches to the management of significant renal trauma, which is potenti...

2001

BJU International, 2013

Objective To detail the 9‐year experience of renal trauma at a modern Level 1 trauma centre and report on patterns of injury, management and complications. Patients and methods We analysed 338 patients with renal injuries who presented to our institution over a 9‐year period. Data on demographics, clinical presentation, management and complications were recorded. Results Males comprised 74.9% of patients with renal injuries and the highest incidence was amongst those aged 20–24 years. Blunt injuries comprised 96.2% (n = 325) of all the renal injuries, with road trauma being the predominant mechanism accounting for 72.5% of injuries. The distribution of injury grade was; 21.6% grade 1 (n = 73), 24.3% grade 2 (n = 82), 24.9% grade 3 (n = 84), 16.6% grade 4 (n = 56), and 12.7% grade 5 (n = 43). Conservative management was successful in all grade 1 and 2 renal injuries, and 94.9%, 90.7% and 35.1% of grade 3, 4 and 5 injuries respectively. All but one of the 13 patients with penetrating ...

Therapeutic Advances in Urology, 2018

The kidneys are the most vulnerable genitourinary organ in trauma, as they are involved in up to 3.25% of trauma patients. The most common mechanism for renal injury is blunt trauma (predominantly by motor vehicle accidents and falls), while penetrating trauma (mainly caused by firearms and stab wound) comprise the rest. High-velocity weapons impose specifically problematic damage because of the high energy and collateral effect. The mainstay of renal trauma diagnosis is based on contrast-enhanced computed tomography (CT), which is indicated in all stable patients with gross hematuria and in patients presenting with microscopic hematuria and hypotension. Additionally, CT should be performed when the mechanism of injury or physical examination findings are suggestive of renal injury (e.g. rapid deceleration, rib fractures, flank ecchymosis, and every penetrating injury of the abdomen, flank or lower chest). Renal trauma management has evolved during the last decades, with a distinct ...

Journal of Academic Emergency Medicine Case Reports, 2010

The kidneys are rarely exposed to trauma by reason of localization. Renal trauma accounts for about 3% of all trauma admissions and as many as 10% of patients who experience abdominal trauma. Our aim is to discuss a case with grade-5 kidney injury which was treated as conservative management. We report a case of isolated renal injury secondary to blunt abdominal trauma which was occured because of a bycyle accident. A 36-year-old male presented with left flank pain and gross hematuria after a bycycle accident with a direct trauma to his loin. After a diagnosis with computed tomography (CT) it was releaved that shattered kidney (grade-5 kidney injury). The patient hospitalized in urology department and has been treated with conservative management. At the end of the treatment he was discharged without any complication. It is considered that conservative management may be succesful in severe renal trauma.

Urologia Internationalis, 2006

a series of 28 patients with renal injury managed at our surgical department. Th e medical records were reviewed for patient age, mechanism of injury, side of injury, signifi cant associated abdominal injuries, physical fi ndings including degree of hematuria, laboratory fi ndings, radiologic imaging, medical and surgical management and the development of major or minor complications.

Radiographics, 2001

Eastern Journal Of Medicine, 2018

Our aim in this study was to retrospectively review the accompanying organ damage, treatment and follow-up processes of patients in our clinic who had had renal trauma within the last five years. 78 patients who were followed due to renal injury were retrospectively reviewed. The cases were evaluated in terms of age, sex, trauma mechanism, accompanying injuries, injury severity, hematuria, treatment type, blood transfusion, hospitalization duration and results. Of the 78 patients, renal injury was observed in 33 (42.3%) patients due to a motor vehicle accident and in 16 (20.5%) patients due to falling. Conservative treatment was applied for 77% (n=60) of the patients, while 23% (n=18) of the patients underwent nephrectomy. The most common intra-abdominal injury was observed as a hepatic injury in 18 (23%) patients. In our study, six (7.7%) of the 78 patients had died. Accompanying organ damage was observed in all patients who died, and all of them had high grade renal injury. Conservative treatment is still important today regardless of the severity of the renal trauma after providing hemodynamic stability. High-grade renal injury and accompanying organ damage are important risk factors in terms of mortality.

Anatolian journal of emergency medicine, 2022

Aim: The ratio of renal traumas among all abdominal traumas is undeniable. With the developing technology, the non-operative approach took place of the operative interventions in the management of renal trauma. In this paper, we compiled a short review about renal trauma and its management based on a patient who was admitted to the emergency department with posttraumatic hematuria. Case: A 29-year-old man is admitted to the emergency department with a complaint of bloody urine and left flank pain. Medical history revealed that he fell down from a height of 1 meter 2 days ago. Left costa-vertebral angle (CVA) tenderness was positive on physical examination. Erythrocyte (1263 P/HPF) and Leukocyte (56 P/HPF) counts were elevated in urinalysis. The patient underwent contrast-enhanced abdominal computed tomography (CT) scan to rule-out kidney injury and left kidney contusion and perirenal hematoma that was in accordance with grade 2 renal injury was detected. No intervention was not considered for the patient, he was admitted to the ward, and he was discharged after an uneventful hospital stay. Conclusion: The incidence of kidney injuries is higher in the young population aged between 31 and 38 years and men account for 72-93% of these cases. Blunt renal injuries, accounting for 71-95 % of renal trauma cases, are more common than penetrating injuries. Motor vehicle accidents are the main cause of blunt trauma, followed by falls, sports, and pedestrian accidents. Up to 95% of blunt renal injuries are minor and treated conservatively as in our case. Currently, conservative management is the preferred therapeutic modality in hemodynamically stable patients with lowgrade kidney injury.