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War injuries of the kidney
H Kuvezdic1, A Tucak, B Grahovac
1Urology Clinic, Clinical Hospital, Osijek, Croatia.
Injury
|October 1, 1996
Summary
War-related penetrating kidney injuries were treated with a high rate of organ-sparing procedures, showing long-term benefits. Rapid patient transport and associated injuries contributed to the high mortality in this study of war trauma.
Area of Science:
- Urology
- Trauma Surgery
- War Surgery
Background:
- Penetrating urogenital injuries, particularly kidney trauma, are significant concerns in conflict zones.
- Understanding the patterns and outcomes of these injuries is crucial for effective management.
Purpose of the Study:
- To analyze the incidence, management, and outcomes of penetrating kidney injuries sustained during wartime.
- To evaluate the effectiveness of organ-sparing surgical approaches in these cases.
Main Methods:
- Retrospective analysis of 4425 wounded patients treated between May 1991 and November 1992.
- Detailed review of 64 patients with penetrating kidney injuries, including injury mechanisms, surgical interventions, and mortality.
- 6-month follow-up evaluation of surviving patients.
Main Results:
- 64 patients (2.6%) presented with penetrating kidney injuries, predominantly caused by fragments (75%) and gunshot wounds (25%).
- Most kidney injuries were associated with other major organ damage, especially abdominal (97%).
- Organ-sparing procedures were performed in 75% of cases, with nephrectomy in 25%. Mortality was 18%, with 7 deaths intraoperatively.
Conclusions:
- The frequency of renal war injuries may be lower than previously reported.
- Transabdominal incision was the preferred surgical approach due to associated abdominal injuries.
- High mortality was linked to associated injuries and rapid transport of critically wounded patients; conserving surgery demonstrated long-term benefits.