Management of high-grade renal injuries in children after blunt abdominal trauma: Experience of 40 cases

2007 ◽  
Vol 3 (3) ◽  
pp. 223-229 ◽  
Author(s):  
Hosni Khairy Salem ◽  
Hani A.A. Morsi ◽  
Ahmad Zakaria
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
High Grade ◽  
Renal Injuries

scholarly journals Non-operative Management of High-grade Renal Injuries in Children: A Review of Two Cases Seen at the Georgetown Public Hospital Corporation

2019 ◽  
pp. 23-24
Author(s):  
Andrea Kissoon ◽  
Marisa Seepersaud ◽  
Pradeep Ramkoomar
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Renal Injury ◽  
Operative Management ◽  
Initial Assessment ◽  
High Grade ◽  
Average Hospital ◽  
Non Operative Management ◽  
Renal Injuries

Purpose:  Blunt abdominal trauma in children results in renal injury in approximately 10 to 20% of cases. In about 20% of these patients, significant complications may arise; for example urinoma (1%) and post trauma extravasation (2-18%). Urinomas and persistent hematuria were traditionally managed surgically by partial or total nephrectomy. Today, nonoperative management is well accepted for the majority of high grade renal injuries, as organ preservation is highly desirable due to patients’ projected lifespan. We present a retrospective review of two cases of high renal injuries seen at GPHC’s Paediatric Surgical Department. Methods: In February and April 2019, two patients met the criteria for grade four renal injury. All medical records were reviewed. Cause of injury, complications, interventions and hospital stay were analyzed. These patients were followed up post discharge, clinically and radiologically. Results: Two males, ages 11 and 10 years, sustained blunt abdominal trauma and presented to GPHC with hematuria and abdominal tenderness. On initial assessment, they were hemodynamically stable and were diagnosed with grade four renal injuries by computed tomography. Complications developed after one week of hospitalization. One patient had persistent hematuria lasting over a week, requiring blood transfusions in excess of 4 units, and the other developed a urinoma, urinary tract infection and deep vein thrombosis. Both patients had paralytic ileus and acute hypertension. These complications were all managed non operatively. The very large urinoma was successfully treated with percutaneous drainage after 25 days. Average hospital stay was 35 days and both patients had complete resolution of their renal injuries within 90 days post trauma. Conclusion: Non operative management of high-grade renal injury is highly successful and safe in children. Even in the presence of significant complications, preservation of renal tissue should be considered.

Congenital cleft spleen with CT scan appearance of high-grade splenic laceration after blunt abdominal trauma

2003 ◽  
Vol 25 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Todd V Brennan ◽  
Gerald S Lipshutz ◽  
Andrew M Posselt ◽  
Jan K Horn
Keyword(s):  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
High Grade ◽  
Congenital Cleft

Severe renal injuries in children following blunt abdominal trauma: selective management and outcome

2011 ◽  
Vol 27 (11) ◽  
pp. 1213-1216 ◽  
Author(s):  
Rajendra B. Nerli ◽  
Tanmaya Metgud ◽  
Shivagouda Patil ◽  
Ajaykumar Guntaka ◽  
P. Umashankar ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Renal Injuries

scholarly journals Management of renal injuries in blunt abdominal trauma

2014 ◽  
Vol 2 (2) ◽  
pp. 38 ◽  
Author(s):  
Parth Patel ◽  
Dipesh Duttaroy ◽  
Samir Kacheriwala
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Renal Injuries

Myth And Facts About The Evolving Role of Laparoscopic Splenectomy In Isolated High Grades Splenic Injuries In Hemodynamically Stable Patients With Blunt Abdominal Trauma. Randomized Controlled Trial.

2021 ◽  
Author(s):  
Tamer.A. A.M. Habeeb ◽  
Gamal Osman ◽  
Amr Ibrahim ◽  
Mohamed Riad ◽  
Abd-Elrahman M. Metwalli ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Laparoscopic Splenectomy ◽  
Splenic Injury ◽  
Laparoscopic Group ◽  
Open Group ◽  
High Grade ◽  
Significant Difference

Abstract Background: Spleen is the most common intra-abdominal organ injury in blunt abdominal trauma. Splenectomy (open or laparoscopic) is the role in treatment of severe injuries of spleen or after failure of conservative treatment.Aim of the work: Compare the outcomes between open versus laparoscopic in high grade splenic injuries.Methods: This study includes 70 patients with various grades of splenic injuries in abdominal trauma. The patients were 15 years and older. They were categorized into two groups: open splenectomy group (35 patients) and laparoscopic splenectomy group (35 patients). The study was performed from January, 2012 to July 2017. Variables included demographics data, splenic injury graded by computerized tomography, duration of operation (in minutes), intra-operative blood loss (in ml), and intraoperative blood transfusion, length of hospital stay (in days), complications and mortality.Results: There was no significant difference or association between groups as regard age, sex and causes of splenic injury (p=0.374, 0.41, 0.38).Most cases were under 35 years old male patients exposed to motor car accidents. As regard intraoperative data, no statistically significant difference between both groups except for blood loss and transfusion that were statistically significant to the open group (p=0.039*).In the laparoscopic group, operational time was longer than open but no statistically significant (p=0.11).as regard conversion, we found that 14% of laparoscopic group (5 cases) had conversion. Most cases operated by laparoscopic approach were in grade III, IV with no cases tried in grade V (p=0.06). No statistically significant difference between both groups as regard postoperative variables except Pain (p=0.0003), and hospital stay(p=0.00) that were significantly longer among open group.The immediate postoperative complications showed that Wound infection, Missed injuries, pancreatic fistula and ileus were significantly higher among open group (p=0.00, 0.006, 0.02, 0.0004).The delayed postoperative complications where Incisional hernia (p=0.001) and Adhesive intestinal obstruction (p=0.00) were significantly associated with open group.Conclusion: In high-grade splenic injuries patients, this study found that laparoscopic splenectomy is safe.

scholarly journals Is there a role of conservative management in high grade pancreatic injuries in Blunt Abdominal Trauma (BAT)?

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S681
Author(s):  
S.R.V. Gunturi ◽  
V. Thumma ◽  
J.R. Bathalapalli ◽  
N. Kunduru ◽  
G.R. Gondu ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Conservative Management ◽  
Blunt Abdominal Trauma ◽  
High Grade ◽  
Pancreatic Injuries

scholarly journals Management of isolated high grade blunt pancreatic injury; case report on lesser aggressive approach

2019 ◽  
Vol 6 (5) ◽  
pp. 1789
Author(s):  
Manjit Singh ◽  
Mritunjay Sarawagi ◽  
Anjay Kumar ◽  
Uday Kumar
Keyword(s):  
Case Report ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Pancreatic Injury ◽  
High Index ◽  
High Grade ◽  
Rare Entity ◽  
Aggressive Approach ◽  
Isolated Pancreatic Injury ◽  
High Index Of Suspicion

Isolated high grade pancreatic injury is rare after blunt abdominal trauma. It is a rare entity to appreciate intra-operatively and a high index of suspicion should always be kept in mind to reach the diagnosis. We are presenting our experience of four cases with moderate to high grade isolated pancreatic injury which were managed in a lesser aggressive approach and had an uneventful outcome.

BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Dhawal Panchal ◽  
Firdaus Dekhaiya ◽  
Harin Tailor
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Blunt Injury ◽  
Abdominal Drainage ◽  
Duration Of Hospital Stay ◽  
Considerable Morbidity ◽  
Injured Patients

In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied  which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients. Keywords:  Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.

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