Pediatric renal trauma: Conservative management

Abstract

The kidney is the most common genitourinary organ injured from external trauma, occurring in 1% to 5% of all injuries. Non operative management of renal injuries with renal salvage as the primary aim has gained much support in the past decades; though paediatric data is limited. Here we present a case of unilateral complete transection managed conservatively and the renal salvage was possible with retaining normal function.

A 7-year retrospective review of renal trauma in paediatric patients in Johannesburg

“…5,6 Paediatric data regarding management of these patients in South Africa is scarce and, internationally, guidelines for the paediatric population have been developed from adult treatment protocols. [6][7][8] Paediatric patients are more prone to renal injuries than adults due to numerous anatomical discrepancies. 1,3,[9][10][11] These include increased renal size in relation to the total body surface area, increased mobility of the kidney, less developed Gerota's fascia, decreased perirenal fat, weaker abdominal muscles, a less ossified thoracic cage and renal lobulations that permit natural transmission of forces along cleavage planes.…”

“…1,3,[9][10][11] These include increased renal size in relation to the total body surface area, increased mobility of the kidney, less developed Gerota's fascia, decreased perirenal fat, weaker abdominal muscles, a less ossified thoracic cage and renal lobulations that permit natural transmission of forces along cleavage planes. 2,6,7,10,12 Renal injury occurs in the presence of accelerationdeceleration forces and rarely occurs in isolation. 6,12 The imaging modalities of choice are ultrasound with a fourphase computed tomography (CT) of the abdomen being the gold standard.…”