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  • Title: [Diagnostic attitude in a patient with kidney trauma].
    Author: Ibáñez Pradas V, Serrano Durbá A, Domínguez Hinarejos C, Estornell Moragues F, Reig Ruiz C, Martínez Verdú M, García Ibarra F.
    Journal: An Esp Pediatr; 1999 Aug; 51(2):136-8. PubMed ID: 10495498.
    Abstract:
    OBJECTIVE: Our aim was to assess our results in the management of renal trauma patients. PATIENTS AND METHODS: A retrospective review of medical charts from 1989 to 1997 was carried out. RESULTS: Twenty-seven cases involving 27 kidneys were treated during the study period, with 16 grade II injuries, 8 grade II and 3 grade III. Ultrasound was the most used diagnostic tool, followed by computerized tomography (CT) and intravenous pyelography (IVP). Falls and traffic accidents were the main etiologic agents (48 and 41%, respectively). Eight out of 11 patients with grade II/III injuries received surgical treatment. Three cases required early surgery immediately after arrival and 5 cases had planned surgery. After a mean follow-up period of 16 months, renal function has remained above 40% in all patients, excluding 3 cases treated with partial nephrectomy. CONCLUSIONS: A conservative attitude is of choice in children with renal trauma. CT is the main diagnostic tool except in patients suspected of isolated grade I injury. Ultrasound followed by IVP is a valid choice for these cases and especially helpful for preschool patients which require general anesthesia for CT exploration.
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