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Nonoperative management of blunt renal injury: a need for further study

Pablo Aguayo1, Jason D Fraser, Susan Sharp

  • 1Department of Surgery, The Children's Mercy Hospital and Clinics, Kansas City, MO 64108, USA.

Journal of Pediatric Surgery
|July 13, 2010
PubMed

Insights

Blunt renal trauma in children rarely leads to severe injury. Hematuria clearance is not a key indicator, suggesting less restrictive management protocols may be safe and effective.

Area of Science:

  • Pediatric Traumatology
  • Urology
  • Nephrology

Background:

  • Blunt renal injury in children is typically managed nonoperatively.
  • Established guidelines for nonoperative management of pediatric blunt renal trauma are lacking.

Purpose of the Study:

  • To review the natural history of blunt renal injuries in children.
  • To identify recommendations for the nonoperative management of these injuries.

Main Methods:

  • Retrospective analysis of 12 years of pediatric blunt renal injury cases.
  • Evaluation of patient demographics, injury characteristics, and management outcomes.

Main Results:

  • 111 pediatric patients with renal injury were identified.
  • Isolated renal injuries (n=65) had short bed rest (3.8 days) and hospitalization (3.8 days).
  • Persistent hematuria did not result in long-term sequelae; no transfusions or nephrectomies were needed in isolated injuries.

Conclusions:

  • Significant injury risk from blunt renal trauma in children is low.
  • Hematuria clearance may not be a critical parameter for management decisions.
  • A more liberal, prospective management protocol for blunt renal trauma in children is warranted.
Abstract

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