Management of renal injury in children

To evaluate types of trauma, other organ injuries and types and results of management in children who were admitted to our clinic because of renal trauma in the last 5 years.

Thirty one patients who were treated in our clinic for renal injury occurring after blunt abdominal trauma between January 2005-2010 were assessed retrospectively.

The patients were aged between 1-16 (mean 8.2) years old. Twenty (64.5%) patients were boys and 11 (35.5%) were girls. The most common causes of injury were falls from height (13 patients, 41.9%). Sixteen patients (52%) had only renal injury and the others (48%) had other organ injuries. Two patients with grade III injury (20%), three patients with grade IV injury (27%) and one patient with grade V injury (100%) were operated on, although all of the patients with grade I and II injuries were managed conservatively. Twenty five patients (81%) were managed conservatively and six patients (19%) whose vital signs were not stable were operated on.

Conservative management should be preferred in patients with renal injuries who are stable hemodynamically. Most renal traumas in children can be treated conservatively. Conservative management has some advantages like shorter hospitalization time, less need for blood transfusion and less morbidity and mortality than surgical management.