Nonoperative management of blunt pediatric major renal trauma.
Publication/Presentation Date
10-1-1993
Abstract
Although algorithms exist for the management of renal trauma in adults, guidelines have not been established in children. Of 1,175 patients entered into our Trauma Registry between 1987 and 1991, 61 (5.2%) presented with gross or microscopic hematuria. Eight of the 58 patients (13.8%) who had blunt abdominal trauma had major renal injuries. Gross hematuria (n = 10) was a significant predictor of major renal injury (n = 5) (p < 0.001). All 3 patients with microscopic hematuria and a major renal injury also had evidence of multisystem trauma. Admission blood pressure, hemoglobin, and trauma score were not predictors of major renal trauma. All cases were managed nonoperatively except for 1 patient who required a partial nephrectomy for continued hemorrhage. These data suggest that hematuria of any degree should be evaluated in the pediatric population, since major injuries can occur with even microscopic hematuria or in the absence of shock. Nonoperative management in this series resulted in no morbidity or delayed complications and suggests that surgical exploration be reserved for ongoing bleeding.
Volume
42
Issue
4
First Page
418
Last Page
424
ISSN
0090-4295
Published In/Presented At
Levy, J. B., Baskin, L. S., Ewalt, D. H., Zderic, S. A., Bellah, R., Snyder, H. M., 3rd, Templeton, J., & Duckett, J. W. (1993). Nonoperative management of blunt pediatric major renal trauma. Urology, 42(4), 418–424. https://doi.org/10.1016/0090-4295(93)90373-i
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
8212441
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article