[Kidney injuries in childhood: our experience in 64 cases]

From 1969 to 1988, 64 children under 5 years of age with renal trauma were treated at our Urology service. Trauma was classified as grade I in 34, grade II in 23, grade III in 3, and 4 patients presented with trauma to pathologic kidney. Eight patients were submitted to immediate surgery (3 grade II, 3 grade III, and 2 with trauma to pathologic kidney). Twelve were initially treated conservatively and were deferred for surgery (11 with grade II trauma and 1 with trauma to pathologic kidney). The remaining 44 patients (34 grade 1, 9 grade II, and 1 with trauma to pathologic kidney) only received medical treatment. The renal unit could be salvaged in 34 cases with grade I trauma (100%) and in 2 of 3 (66.6%) with grade III trauma who underwent immediate surgery. In patients with grade II trauma submitted to immediate surgery, 1 out of 3 patients (33.3%) required a nephrectomy procedure, whereas in those patients submitted to conservative treatment and or deferred surgery, only 1 out of 20 (5%) required a nephrectomy procedure. The results reported in the literature are discussed and compared with our results.