A clinical observation was made on 37 patients with renal injuries, who were admiltted to the Department of Urology, Chungnam National University Hospital from January 1983 to September 1987.
Most of the patients (33 of 37) were male and 16 patients (43%) were in the age group of third decade. Blunt renal trauma were 36 patients, penetrating injury, 1 patient and common causes of injury were traffic accident in 16 patients (43%), blow in 12 patients (32%) and fall in 7 patients (19%). Associated injuries were noted in 31% of patients with the majority of rib fracture. The most frequent symptoms and signs were hematuria and flank pain. Renal injuries were classified as minor, major and pedicle injury according to modified Scott´s classification. Of the 37 patients, 19(51%) were minor injury, 15(41%), major injury and 3(8%), pedicle injury.
Excretory urography was the commonest diagnostic procedure and is considered to be the screening procedure of choice. The predominat pyelographic findings of cortical laceration were extravasation of dye and distorted and displaced calyx and those of major injury were extravasation of dye, nephrogram defect, and displaced kidney and ureter. Selective renal arterio-or venography is considered to be the good diagnostic procedure in case of major and pedicle injury for planning the proper treatment.
Of the 19% with minor injury, conservative treatment was performed in 16 patients, repair of renal laceration in 2 and nephrectomy in 1 due to severe hydronephrosis. Of the 15 patients with major injury, nephrectomy was done in 9, heminephrectomy in 3 and repair of renal laceration in 3. Of the 3 patients with pedicle injury, nephrectomy was done in 2 and anticoagulant therapy in 1 suspected of renal vein thrombosis.
|