Acute Renal Trauma

2020 ◽  
Vol 23 (1) ◽  
pp. 37-39
Author(s):  
KABM Taiful Alam ◽  
Sumon Rahmon ◽  
Nazmul Hossain ◽  
Digonto Ckakma
Keyword(s):  
Blunt Trauma ◽  
Renal Injury ◽  
Left Kidney ◽  
Renal Trauma ◽  
Retroperitoneal Haematoma ◽  
Operative Recovery ◽  
Primary Management

The kidney is the most commonly injured genitourinary organ. Most injuries can be managed conservatively but nephrectomy may be needed in case of shuttered or avulsed kidney. Here we present a case of haematuria with blunt trauma to the abdomen. The patient was haemodynamically unstable and his abdomen was distended and rigid. FAST revealed intraabdominal and retroperitoneal haematoma with left renal injury. After rapid primary management emergency nephrectomy had done as there were multiple lecerations and avulsion in the left kidney. Post operative recovery and subsequent follow up was uneventful. Journal of Surgical Sciences (2019) Vol. 23 (1) : 37-39

Observation and treatment of renal trauma: 3 years experience

1992 ◽  
Vol 59 (1_suppl) ◽  
pp. 113-115
Author(s):  
F. Cappellano ◽  
F. Catanzaro ◽  
E. Della Morte ◽  
M. Baruffi ◽  
F. Torelli ◽  
...  
Keyword(s):  
Ct Scan ◽  
Renal Injury ◽  
Penetrating Injury ◽  
Renal Trauma ◽  
Trauma Patients ◽  
Radiological Investigation ◽  
Long Term Follow Up

The investigation and management of renal trauma have evolved during the last 15 years. The majority of patients with renal trauma can be treated conservatively with minimal radiological investigations, since the outcome is excellent in most cases. A CT scan is the radiological investigation of choice in most cases of renal trauma when the patient is hemodynamically stable and there is suspicion that he has suffered a major renal injury. Long term follow-up of renal trauma patients treated conservatively is needed to examine possible complications. We report our experience on 87 patients presenting a complication in a penetrating injury.

Management of renal injury in a UK major trauma centre

Trauma ◽  
2018 ◽  
Vol 22 (1) ◽  
pp. 26-31
Author(s):  
Robert Torrance ◽  
Abigail Kwok ◽  
David Mathews ◽  
Matthew Elliot ◽  
Andrew Baird ◽  
...  
Keyword(s):  
Renal Injury ◽  
Major Trauma ◽  
Trauma Centre ◽  
University Hospital ◽  
Research Network ◽  
Renal Trauma ◽  
High Grade ◽  
Major Trauma Centre ◽  
Renal Injuries

Introduction This study reviews the type, severity, management and follow-up of renal trauma presenting to a major trauma centre in the northwest of England in the four years following inception of the major trauma centre. Given the recent introduction of major trauma centres nationally, research is needed within every specialty to ensure that the centralisation of services benefits all patients affected by these changes. Methods Patients presenting to Aintree University Hospital with renal trauma between June 2012 and June 2016 were identified using the Trauma Audit and Research Network (TARN) database. The data gathered retrospectively for each patient included mechanism of injury, injury severity score, American Association for the Surgery of Trauma (AAST) grading, management of injury, and follow-up. Results Out of a total of 2595 trauma patients, 33 renal injuries were identified. The 31 patients who received imaging were classified according to AAST grading, with 8 Grade I (25.8%), 4 Grade II (12.9%), 8 Grade III (25.8%), 4 Grade IV (12.9%), and 7 Grade V (22.6%) injuries. Twenty-five out of the 30 surviving patients received conservative treatment, three patients received angioembolisation (AE), one patient received a laparotomy with renal suturing, and one patient required a nephrectomy. Of these 30 surviving patients, seven received urology follow-up in clinic (23%). Conclusion The findings appear to support the growing trend towards the conservative management of high-grade renal injuries, and provide further evidence for the value of AE in renal trauma. The success of AE in this study appears to support the centralisation of services in renal trauma; however, the low nephrectomy rate could be interpreted as suggestive of the opposite. The study revealed that improvements to follow-up are needed, and that further research should seek to inform the optimal radiological follow-up of high-grade renal injury.

scholarly journals Intraparenchymal Renal Artery Pseudoaneurysm and Arteriovenous Fistula on a Solitary Kidney Occurring 38 Years after Blunt Trauma

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Daniel Benamran ◽  
Benedicte de Clippele ◽  
Frank Hammer ◽  
Bertrand Tombal
Keyword(s):  
Renal Artery ◽  
Arteriovenous Fistula ◽  
Blunt Trauma ◽  
Left Kidney ◽  
Solitary Kidney ◽  
Endovascular Embolization ◽  
Artery Pseudoaneurysm ◽  
Kidney Trauma ◽  
Renal Artery Pseudoaneurysm

Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma. Those conditions were successfully treated by endovascular embolization followed by regular radiologic, biological, and clinical follow-up. To the best of our knowledge, few similar cases were reported more than 20 years after trauma. However, no case combining an arteriovenous fistula and a pseudoaneurysm revealing as late as 38 years after trauma was found. In addition, management of those conditions on a solitary kidney and outcomes has not been described. We believe that our case depicts the clinical presentation and management of this rare entity that should not be unrecognized due to its potential lethal implications.

The diagnosis and management of renal trauma

2017 ◽  
Vol 11 (1) ◽  
pp. 70-76
Author(s):  
James Austin ◽  
Govindaraj Rajkumar
Keyword(s):  
Renal Injury ◽  
Renal Trauma ◽  
Haemodynamic Instability ◽  
Computerised Tomography ◽  
Diagnosis And Management ◽  
Urine Extravasation ◽  
Low Threshold

Background: Renal trauma is less common but often occurs in polytrauma. Most trauma is blunt and the severity of the injury varies in different circumstances. Assessment: There is a series of features that should prompt investigation but none are reliably seen in all trauma cases and a low threshold for suspecting renal injury should be taken. A urine dip is essential. Investigation: Computerised tomography is the main modality. Follow-up imaging may be used if complications arise and ultrasound may be used in some cases. Management: Approaches include surgical, radiological and conservative. The latter has been achieved in all grades but intervention will be required in haemodynamic instability. Complications: Haemorrhage, infection and urine extravasation are common and require intervention. There are many long-term complications and hypertension can occur by a variety of mechanisms.

scholarly journals Pediatric blunt renal trauma with wide fragments dislocation: successful organ saving management by internal stenting and percutaneous perirenal drain

2014 ◽  
Vol 36 (5-6) ◽  
Author(s):  
C. Olivieri ◽  
M.G. Grella ◽  
V.D. Catania ◽  
A.C. Contini ◽  
V. Briganti ◽  
...  
Keyword(s):  
High Risk ◽  
Blunt Trauma ◽  
Conservative Management ◽  
Renal Injury ◽  
Renal Damage ◽  
Renal Trauma ◽  
High Grade

Children have an high risk of renal damage as a result of blunt trauma. Conservative management is always recommended for lower grades (I to III) but is rather controversial whenever high grade injuries (grade IV and V) are concerned. We describe a case of successful conservative management in grade IV renal injury occurred in a 9-years-old girl with blunt trauma.

170: Nonoperative Management of Blunt Renal Trauma: Is Routine Follow-Up Imaging Necessary?

2007 ◽  
Vol 177 (4S) ◽  
pp. 57-58
Author(s):  
John B. Malcolm ◽  
Reza Mehrazin ◽  
Christopher J. DiBlasio ◽  
David D. Vance ◽  
Robert W. Wake ◽  
...  
Keyword(s):  
Nonoperative Management ◽  
Renal Trauma

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

Postnatal ultrasound follow-up in neonates with prenatal hydronephrosis

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Elham Kebriyaei ◽  
Ali Davoodi ◽  
Seyed Alinaghi Kazemi ◽  
Zahra Bazargani
Keyword(s):  
Ultrasound Imaging ◽  
Maternal Education ◽  
Left Kidney ◽  
Ultrasound Images ◽  
Fetal Ultrasound ◽  
Renal Anomalies ◽  
Cross Sectional ◽  
Fetal Hydronephrosis ◽  
Kidney Involvement

Abstract Objectives Renal anomalies are the most common fetal abnormalities that occur during prenatal development, and are typically detected by observing hydronephrosis on fetal ultrasound imaging. Follow-up with post-natal ultrasound is important to detect clinically-important obstruction, because many of the pre-natal abnormalities resolve spontaneously. This study aimed to evaluate the postnatal hydronephrosis follow-up rate, and reasons for non follow-up in affected neonates. Methods In this cross-sectional study all neonates born during a period of one year at Ayatollah Mousavi Hospital with hydronephrosis on fetal ultrasound imaging were recruited. All mothers were also given face-to-face information about fetal hydronephrosis and its postnatal outcomes, and follow-up with at least a postnatal ultrasound was recommended from the fourth day of their neonates’ birth until the end of the fourth week. The neonates were subsequently observed for one month to determine the postnatal ultrasound follow-up rate and to reflect on diagnostic test results, reasons for failure to follow-up, as well as causes of hydronephrosis. Results In this study, 71 cases (1.2%) out of 5,952 neonates had fetal hydronephrosis on prenatal ultrasound images. The postnatal ultrasound imaging showed kidney involvement in 18 neonates (25%), particularly in the left kidney (61.1%). Seven neonates had no follow-up at one month (10%). No significant relationship was found between lack of follow-up and the neonates’ place of residence (p=0.42), maternal education (p=0.90), number of siblings (p=0.33), or gender (p=0.64). Conclusions Postnatal ultrasound follow-up rate in these neonates with a history of fetal hydronephrosis was incomplete even though parents had been provided with education and advice at their birth time. Accordingly, it is recommended to perform postnatal ultrasound once neonates are discharged from hospitals.

scholarly journals Role of Invasive Urodynamic Studies in Establishing Cauda Equina Syndrome and Postoperative Recovery

2020 ◽  
pp. 219256822097964
Author(s):  
Abhinandan Reddy Mallepally ◽  
Bibhudendu Mohapatra ◽  
Kalidutta Das
Keyword(s):  
Clinical Symptoms ◽  
False Positive Rate ◽  
Cauda Equina ◽  
Postoperative Recovery ◽  
Normal Bladder ◽  
Acontractile Detrusor ◽  
Positive Rate ◽  
Acute Radiculopathy ◽  
Operative Recovery

Study design: Retrospective with prospective follow-up. Objective: Confirming the diagnosis of CES based purely on symptoms and signs is unreliable and usually associated with high false positive rate. A missed diagnosis can permanently disable the patient. Present study aims to determine the relationship between clinical symptoms/ signs (bladder dysfunction) with UDS, subsequently aid in surgical decision making and assessing post-operative recovery. Methods: A prospective follow-up of patients with disc herniation and bladder symptoms from January 2018 to July 2020 was done. All patients underwent UDS and grouped into acontractile, hypocontractile and normal bladder. Data regarding PAS, VAC, GTP, timing to surgery and onset of radiculopathy and recovery with correlation to UDS was done preoperatively and post operatively. Results: 107 patients were studied (M-63/F-44). Patients with PAS present still had acontractile (61%) or hypocontractile (39%) detrusor and with VAC present, 57% had acontractile and 43% hypocontractile detrusors. 10 patients with both PAS and VAC present had acontractile detrusor. 82% patients with acute radiculopathy (<2 days) improved when operated <24 hrs while only 47% showed improvement with chronic radiculopathy. The detrusor function recovered in 66.1% when operated <12 hours, 40% in <12-24 hours of presentation. Conclusion: Adjuvant information from UDS in combination with clinicoradiological findings help in accurate diagnosis even in patients with no objective motor and sensory deficits. Quantitative findings on UDS are consistent with postoperative recovery of patient’s urination power, representing improvement and can be used as a prognostic factor.

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