Ureteropelvic junction disruption following blunt abdominal trauma

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Published on: October 12, 2017

Wolfgang Pumberger1, Elisabeth Stoll, Sylvia Metz

  • 1Division of Pediatric Surgery, Department of Pediatric Intensive Care, University of Vienna, Austria.

Pediatric Emergency Care
|October 24, 2002
PubMed

Insights

A 7-year-old boy sustained a rare ureteropelvic junction avulsion after a car accident. Surgical repair was successful, highlighting this unusual traumatic injury in pediatric patients.

Area of Science:

  • Pediatric Traumatology
  • Urology
  • Nephrology

Background:

  • Blunt abdominal trauma can cause significant internal injuries.
  • Avulsion of the ureteropelvic junction is an uncommon but severe consequence of high-energy impact.
  • Pediatric patients present unique challenges in trauma management.

Observation:

  • A 7-year-old boy experienced severe brain trauma and subsequent abdominal distension post-car accident.
  • Initial assessment prioritized the brain injury, delaying abdominal trauma evaluation.
  • Progressive abdominal distension prompted further investigation 24 hours after the incident.

Findings:

  • Ultrasound and computed tomography (CT) scans confirmed a complete disruption of the ureteropelvic junction.
  • The injury involved the separation of the renal pelvis from the ureter.
  • Surgical intervention involved a simple primary anastomosis to restore urinary continuity.

Implications:

  • This case underscores the importance of a high index of suspicion for intra-abdominal injuries in pediatric trauma, even with concurrent severe head injuries.
  • Early diagnosis and prompt surgical management are crucial for favorable outcomes in ureteropelvic junction avulsion.
  • Understanding the mechanisms and management of such rare injuries aids in improving pediatric trauma care protocols.

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