Related Experiment Videos
Blunt renal trauma-blessing in disguise?
Priya Chopra1, Dickens St-Vil, Salam Yazbeck
1Montreal, Quebec.
Journal of Pediatric Surgery
|May 3, 2002
Summary
Pediatric blunt renal trauma can reveal uncommon urinary tract pathologic lesions, necessitating modified diagnostic and therapeutic approaches. A high index of suspicion for these conditions is crucial, especially with gross hematuria following minimal trauma.
Area of Science:
- Pediatric Urology
- Trauma Surgery
- Diagnostic Imaging
Background:
- Blunt renal trauma in children can present with coexisting urogenital anomalies.
- Incidental findings during trauma workup highlight the importance of comprehensive evaluation.
Purpose of the Study:
- To quantify the occurrence and types of pathologic kidney lesions found incidentally in pediatric patients with blunt renal trauma.
- To assess the management and outcomes of these coexisting lesions.
Main Methods:
- Retrospective review of 103 pediatric patients (0-18 years) with blunt renal injuries.
- Utilized ultrasonography, Doppler, CT scans, cystography, and nuclear medicine studies as indicated.
- Analyzed medical records for identified urogenital lesions and subsequent treatments.
Main Results:
- 12.6% of patients (13/103) had coexisting urogenital lesions, with 54% requiring surgery.
- Uretero-pelvic junction stenosis was most frequent (n=7), leading to reconstructive surgery or nephrectomy.
- Two suspected malignant renal masses were resected, later confirmed as benign cystic conditions.
Conclusions:
- Pathologic urinary tract lesions are infrequent but can complicate seemingly minor renal trauma.
- Diagnostic and therapeutic strategies for blunt renal trauma should be adapted to include evaluation for these lesions.
- Gross hematuria after minimal blunt abdominal trauma warrants a high suspicion for underlying pathologic urinary tract conditions.