Renal trauma in childhood. Second-level hospital experience
Baeza-Herrera, C.; Domínguez-Pérez, S.ón.T.; González-Zarate, E.F.; García-Cabello, L.M.; Nájera-Garduño, H.M.; Gaspar-Ramírez, G.
Gaceta Medica de Mexico 138(4): 313-318
2002
ISSN/ISBN: 0016-3813 PMID: 12200875 Document Number: 550010
The leading cause of death in children is accidents. Severe craniocerebral trauma and injuries to the heart or major vessels are mainly responsible for immediate death. This phenomenon is also reflected in the increasing number of pediatric admissions for renal trauma. From 1990 to 2000, the charts of 132 patients with renal injuries secondary to blunt and penetrating trauma in childhood are reviewed. A total of 88 were male patients and 126 sustained blunt trauma (motor accidents, falls, etc.). Gross and microscopic hematuria were the most important finding at the time of presentation, and correlated with severe renal injury, and both were present in 122 cases. Intravenous pyelography and CT scan were the most useful diagnosis tools. Only 27 patients were managed operatively, the majority because of associated intra-abdominal injury. Intravenous pyelography remains the most cost-effective means of investigating renal injuries in a second-level hospital. Renal contusion and most laceration should be managed conservatively. Only few a renal transactions should be managed operatively.