Journal of Emergencies, Trauma, and Shock
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Year : 2017  |  Volume : 10  |  Issue : 3  |  Page : 140-145

Characteristics and management of blunt renal injury in children

Department of Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA

Correspondence Address:
Yuichi Ishida
Department of Surgery, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, Texas 79905
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_93_16

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Background: Renal trauma in the pediatric population is predominately due to blunt mechanism of injury. Our purpose was to determine the associated injuries, features, incidence, management, and outcomes of kidney injuries resulting from blunt trauma in the pediatric population in a single level I trauma center. Methods: This was a retrospective chart and trauma registry review of all pediatric blunt renal injuries at a regional level I trauma center that provides care to injured adults and children. The inclusion dates were January 2001–June 2014. Results: Of 5790 pediatric blunt trauma admissions, 68 children sustained renal trauma (incidence: 1.2%). Only two had nephrectomies (2.9%). Five renal angiograms were performed, only one required angioembolization. Macroscopic hematuria rate was significantly higher in the high-grade injury group (47% vs. 16%; P = 0.031). Over half of the patients had other intra-abdominal injuries. The liver and spleen were the most frequently injured abdominal organs. Conclusion: Blunt renal trauma is uncommon in children and is typically of low American Association for the Surgery of Trauma injury grade. It is commonly associated with other intra-abdominal injuries, especially the liver and the spleen. The nephrectomy rate in pediatric trauma is lower compared to adult trauma. Most pediatric blunt renal injury can be managed conservatively by adult trauma surgeons.

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