Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00029029.xml
Download PDF
J Pediatr Intensive Care 2015; 04(01): 016-020
DOI: 10.1055/s-0035-1554984
DOI: 10.1055/s-0035-1554984
Review Article
Blunt Renal Trauma
Further Information
Publication History
05 October 2014
10 November 2014
Publication Date:
13 July 2015 (online)
Abstract
The pediatric patient is especially prone to blunt renal trauma due to the size and location of pediatric kidneys. No clear guidelines have been established for the management of these injuries in children to achieve the highest rate of renal salvage with low morbidity. Wide-ranging literature exists on this subject, but consists of vastly different management strategies. This review is written to summarize the different approaches to blunt renal trauma and highlight opportunities for further research.
-
References
- 1 Brown SL, Elder JS, Spirnak JP. Are pediatric patients more susceptible to major renal injury from blunt trauma? A comparative study. J Urol 1998; 160 (1) 138-140
- 2 Kuzmarov IW, Morehouse DD, Gibson S. Blunt renal trauma in the pediatric population: a retrospective study. J Urol 1981; 126 (5) 648-649
- 3 Smith MJ, Seidel RF, Bonacarti AF. Accident trauma to the kidneys in children. J Urol 1966; 96 (6) 845-847
- 4 Miller KS, McAninch JW. Radiographic assessment of renal trauma: our 15-year experience. J Urol 1995; 154 (2 Pt 1) 352-355
- 5 Heyns CF. Renal trauma: indications for imaging and surgical exploration. BJU Int 2004; 93 (8) 1165-1170
- 6 Santucci RA, Langenburg SE, Zachareas MJ. Traumatic hematuria in children can be evaluated as in adults. J Urol 2004; 171 (2 Pt 1) 822-825
- 7 Smith JK, Kenney PJ. Imaging of renal trauma. Radiol Clin North Am 2003; 41 (5) 1019-1035
- 8 Abou-Jaoude WA, Sugarman JM, Fallat ME, Casale AJ. Indicators of genitourinary tract injury or anomaly in cases of pediatric blunt trauma. J Pediatr Surg 1996; 31 (1) 86-89 , discussion 90
- 9 Cass AS, Luxenberg M, Gleich P, Smith CS. Clinical indications for radiographic evaluation of blunt renal trauma. J Urol 1986; 136 (2) 370-371
- 10 Hashmi A, Klassen T. Correlation between urinalysis and intravenous pyelography in pediatric abdominal trauma. J Emerg Med 1995; 13 (2) 255-258
- 11 Fleisher G. Prospective evaluation of selective criteria for imaging among children with suspected blunt renal trauma. Pediatr Emerg Care 1989; 5 (1) 8-11
- 12 Perez-Brayfield MR, Gatti JM, Smith EA , et al. Blunt traumatic hematuria in children. Is a simplified algorithm justified?. J Urol 2002; 167 (6) 2543-2546 , discussion 2546–2547
- 13 Schmidlin FR, Iselin CE, Naimi A , et al. The higher injury risk of abnormal kidneys in blunt renal trauma. Scand J Urol Nephrol 1998; 32 (6) 388-392
- 14 Brown SL, Haas C, Dinchman KH, Elder JS, Spirnak JP. Radiologic evaluation of pediatric blunt renal trauma in patients with microscopic hematuria. World J Surg 2001; 25 (12) 1557-1560
- 15 Chowdhary SK, Pimpalwar A, Narasimhan KL, Katariya S, Rao KL. Blunt injury of the abdomen: a plea for CT. Pediatr Radiol 2000; 30 (11) 798-800
- 16 Hom J. The risk of intra-abdominal injuries in pediatric patients with stable blunt abdominal trauma and negative abdominal computed tomography. Acad Emerg Med 2010; 17 (5) 469-475
- 17 Bartley JM, Santucci RA. Computed tomography findings in patients with pediatric blunt renal trauma in whom expectant (nonoperative) management failed. Urology 2012; 80 (6) 1338-1343
- 18 Streck Jr CJ, Jewett BM, Wahlquist AH, Gutierrez PS, Russell WS. Evaluation for intra-abdominal injury in children after blunt torso trauma: can we reduce unnecessary abdominal computed tomography by utilizing a clinical prediction model?. J Trauma Acute Care Surg 2012; 73 (2) 371-376 , discussion 376
- 19 de Jong WJ, Stoepker L, Nellensteijn DR, Groen H, El Moumni M, Hulscher JB. External validation of the Blunt Abdominal Trauma in Children (BATiC) score: ruling out significant abdominal injury in children. J Trauma Acute Care Surg 2014; 76 (5) 1282-1287
- 20 Karam O, Sanchez O, Chardot C, La Scala G. Blunt abdominal trauma in children: a score to predict the absence of organ injury. J Pediatr 2009; 154 (6) 912-917
- 21 Fraser JD, Aguayo P, Ostlie DJ, St Peter SD. Review of the evidence on the management of blunt renal trauma in pediatric patients. Pediatr Surg Int 2009; 25 (2) 125-132
- 22 Wessel LM, Scholz S, Jester I , et al. Management of kidney injuries in children with blunt abdominal trauma. J Pediatr Surg 2000; 35 (9) 1326-1330
- 23 Aguayo P, Fraser JD, Sharp S, Holcomb III GW, Ostlie DJ, St Peter SD. Nonoperative management of blunt renal injury: a need for further study. J Pediatr Surg 2010; 45 (6) 1311-1314
- 24 Buckley JC, McAninch JW. Pediatric renal injuries: management guidelines from a 25-year experience. J Urol 2004; 172 (2) 687-690 , discussion 690
- 25 Fitzgerald CL, Tran P, Burnell J, Broghammer JA, Santucci R. Instituting a conservative management protocol for pediatric blunt renal trauma: evaluation of a prospectively maintained patient registry. J Urol 2011; 185 (3) 1058-1064
- 26 Henderson CG, Sedberry-Ross S, Pickard R , et al. Management of high grade renal trauma: 20-year experience at a pediatric level I trauma center. J Urol 2007; 178 (1) 246-250 , discussion 250
- 27 Nerli RB, Metgud T, Patil S , et al. Severe renal injuries in children following blunt abdominal trauma: selective management and outcome. Pediatr Surg Int 2011; 27 (11) 1213-1216
- 28 Umbreit EC, Routh JC, Husmann DA. Nonoperative management of nonvascular grade IV blunt renal trauma in children: meta-analysis and systematic review. Urology 2009; 74 (3) 579-582
- 29 Dent D, Alsabrook G, Erickson BA , et al. Blunt splenic injuries: high nonoperative management rate can be achieved with selective embolization. J Trauma 2004; 56 (5) 1063-1067
- 30 Olthof DC, Joosse P, van der Vlies CH, de Haan RJ, Goslings JC. Prognostic factors for failure of nonoperative management in adults with blunt splenic injury: a systematic review. J Trauma Acute Care Surg 2013; 74 (2) 546-557
- 31 Nuss GR, Morey AF, Jenkins AC , et al. Radiographic predictors of need for angiographic embolization after traumatic renal injury. J Trauma 2009; 67 (3) 578-582 , discussion 582
- 32 Davies DA, Ein SH, Pearl R , et al. What is the significance of contrast “blush” in pediatric blunt splenic trauma?. J Pediatr Surg 2010; 45 (5) 916-920
- 33 van der Vlies CH, Saltzherr TP, Wilde JC, van Delden OM, de Haan RJ, Goslings JC. The failure rate of nonoperative management in children with splenic or liver injury with contrast blush on computed tomography: a systematic review. J Pediatr Surg 2010; 45 (5) 1044-1049
- 34 Kiankhooy A, Sartorelli KH, Vane DW, Bhave AD. Angiographic embolization is safe and effective therapy for blunt abdominal solid organ injury in children. J Trauma 2010; 68 (3) 526-531
- 35 Graziano KD, Juang D, Notrica D , et al. Prospective observational study with an abbreviated protocol in the management of blunt renal injury in children. J Pediatr Surg 2014; 49 (1) 198-200 , discussion 200–201
- 36 Stylianos S ; The APSA Trauma Committee. Evidence-based guidelines for resource utilization in children with isolated spleen or liver injury. J Pediatr Surg 2000; 35 (2) 164-167 , discussion 167–169
- 37 St Peter SD, Aguayo P, Juang D , et al. Follow up of prospective validation of an abbreviated bedrest protocol in the management of blunt spleen and liver injury in children. J Pediatr Surg 2013; 48 (12) 2437-2441
- 38 McVay MR, Kokoska ER, Jackson RJ, Smith SD. Throwing out the “grade” book: management of isolated spleen and liver injury based on hemodynamic status. J Pediatr Surg 2008; 43 (6) 1072-1076
- 39 Nance ML, Lutz N, Carr MC, Canning DA, Stafford PW. Blunt renal injuries in children can be managed nonoperatively: outcome in a consecutive series of patients. J Trauma 2004; 57 (3) 474-478 , discussion 478
- 40 Ahmed S, Morris LL. Renal parenchymal injuries secondary to blunt abdominal trauma in childhood: a 10-year review. Br J Urol 1982; 54 (5) 470-477
- 41 Margenthaler JA, Weber TR, Keller MS. Blunt renal trauma in children: experience with conservative management at a pediatric trauma center. J Trauma 2002; 52 (5) 928-932
- 42 Broghammer JA, Langenburg SE, Smith SJ, Santucci RA. Pediatric blunt renal trauma: its conservative management and patterns of associated injuries. Urology 2006; 67 (4) 823-827
- 43 Philpott JM, Nance ML, Carr MC, Canning DA, Stafford PW. Ureteral stenting in the management of urinoma after severe blunt renal trauma in children. J Pediatr Surg 2003; 38 (7) 1096-1098
- 44 Rogers CG, Knight V, MacUra KJ, Ziegfeld S, Paidas CN, Mathews RI. High-grade renal injuries in children—is conservative management possible?. Urology 2004; 64 (3) 574-579
- 45 Malcolm JB, Derweesh IH, Mehrazin R , et al. Nonoperative management of blunt renal trauma: is routine early follow-up imaging necessary?. BMC Urol 2008; 8: 11
- 46 Breen KJ, Sweeney P, Nicholson PJ, Kiely EA, O'Brien MF. Adult blunt renal trauma: routine follow-up imaging is excessive. Urology 2014; 84 (1) 62-67