Transcatheter embolization in pediatric blunt renal trauma: Case report and review of the literature

Abstract

This study aims to evaluate the clinical use and outcomes of transcatheter embolization in the setting of pediatric blunt renal trauma cases using an index case and review of the literature. Although the treatment method selection depends on the grade of the trauma and the hemodynamıc status of the patient, conservative methods are considered initially in the setting of pediatric blunt renal trauma. Transcatheter embolization, which is a relatively conservative treatment option, is commonly utilized in adult blunt renal trauma patient population; however, experience in the pediatric population is scarce. A seven-year-old male patient was admitted due to grade IV renal injury secondary to blunt abdominal trauma. He was conservatively followed until -on the post-trauma day 15-he developed gross hematuria and an unstable hemodynamic status. A renal angiogram was performed, which revealed rightsided renal inferior segmental artery pseudoaneurysm and arterio-venous fistula. Subsequently, a transcatheter embolization was performed. There were no complications and no permanent renal injury. Review of the literature revealed that the success rate of transcatheter embolization is 89.47% in the setting of pediatric blunt abdominal trauma-related renal injury regardless of the renal trauma grade. Four patients underwent nephrectomy due to a failed transcatheter embolization procedure. There are not any patients who suffered from embolization-related complications. These results suggest that transcatheter embolization can be safely performed in children with renal injuries due to blunt abdominal trauma with high success and low complication rates and preservation of renal function.