MANAGEMENT OF RENAL TRAUMA : OUR EXPERIENCE

INTRODUCTION:The kidney is the most commonly injured genitourinary organ in 1-5% of all trauma patients.Blunt trauma is the most common mechanism of injury although penetrating injuries are becoming more common due to increasing violence.The management of patients with blunt abdominal injury has evolved greatly over the last few decades.Although renal trauma can be life threatening, most injures can be managed conservatively.AIMS AND OBJECTIVES: To evaluate the efficacy, safety and outcome of the conservative management of renal trauma and to study the role of surgical management of renal trauma in the present era.MATERIALS AND METHODS: From January 2012 to December 2013 42 patients admitted to our department with renal trauma were analyzed.All the patients were initially managed by resuscitation.The diagnosis was made by physical examination, clinical findings supported by plain X-ray abdomen erect posture, ultrasound Abdomen, CECT Abdomen.Associated organ system injuries were addressed accordingly.Stabilized patients (grade I-III) were kept on conservative management.Some grade IV and all grade V cases were taken up for surgery.RESULTS: Highest incidence of renal trauma was observed in 2nd and 3rd decade of life.Youngest being 6 years old and eldest was 55 years old.35 males and 7 females.Blunt injury in 38 cases, stab in 2, fall on to a rod -1, gunshot-1.Majority presented with hematuria and flank pain.27 presented with minor injuries requiring conservative management.15 presented with grade V injuries.Out of which 3 responded to conservative management 12 required surgery.CONCLUSION: in patients with AAST Grade I, II, III conservative management proven to have good success rate and high renal salvage.In AAST -Grade IV with other abdominal injuries renal preservation strategies were effective & successful.