Renal Trauma: A 5-Year Retrospective Review from a Level 1 Trauma Center
DOI:
https://doi.org/10.24915/aup.205Keywords:
Kidney/injuriesAbstract
Introduction: Renal trauma accounts for about 1% to 5% of all trauma patients, the majority of which are due to blunt trauma. Based on the American Association for the Surgery of Trauma (AAST) classification we can classify renal trauma into five grades of injury, which can help choosing the adequate treatment and anticipate the outcome. Management of renal trauma is evolving to a more conservative approach, avoiding surgery when it is possible.Our objective was to analyse our 5-year experience of renal trauma at a level 1 trauma center and report the patterns of injury, management and complications.
Methods: Retrospective analysis of patients diagnosed with renal trauma at a level 1 trauma center between January 2017 and December 2021. Data were collected from electronic patient records.
Results: During this period of time, we identified 29 patients, 93.1% male, admitted due to renal trauma. Median age was 48 years old. The majority had a blunt trauma (89.7%). The distribution of injury grade according to the AAST classification was: 6.9% grade I, 13.8% grade II, 41.4% grade III, 31% grade IV and 6.9% grade V. No patient died due to this trauma. A percentage of 43.3% of patients were treated conservatively, 6.7% with embolization by interventional radiology, 30.0% with a double J ureteral stent and 20.0% with nephrectomy. Early complications were observed in 34.4% of the patients.
Conclusion: The vast majority of renal injuries were due to blunt trauma, as expected. At this moment, management of renal trauma is trending to a more conservative approach, but in our sample, half of the patients needed intervention, mainly due to urinary extravasation but also because active bleeding and unfavourable clinical evolution. Nephrectomies were performed almost exclusively in grade 4 or 5 of injury. Early complications were more frequent than expected, mainly due to infection, in spite of empiric antibiotic therapy have been done in all patients.
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