Closed kidney injuries in children

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Abstract

MATERIALS AND METHODS: Within 20 yrs, 76 children aged 2–8 yrs with kidney trauma were under observation, and 35 of them had associated trauma. Clinical, instrumental, and radiological methods were used in the diagnosis.

RESULTS: Of the 76 children with closed kidney trauma, 23 were diagnosed with kidney contusion, 14 with kidney injury with subcapsular hematoma, 16 with kidney injury with rupture of the capsule and perirenal urohematoma, 21 with kidney rupture and damage to the calyx–pelvic system, and 2 with traumatic hydronephrotic kidney. Conservative treatment was carried out in 49 (64.4%) children and surgical treatment in 28 (25.6%). In the long term, 28 children with kidney injuries and treated conservatively were examined. Complications were found in nine children: pyeloectasia, deformation of the calyx–pelvic system, pyelonephritis, and renal hypertension. Organ-preserving surgery was performed in 22 (28.9%) children and nephrectomy in 5 (6.6%) children. As long-term results: the function of the operated kidneys was satisfactory, some changes occurred in the calyx–pelvic systems, and no data for pyelonephritis was found.

CONCLUSION: Renal injuries with subcapsular rupture and perirenal urohematoma should be surgically treated to prevent severe long-term complications. In unclear cases, the choice can be a two-stage organ-preserving operation for the so-called crushing of the kidney.

About the authors

Anatoly E. Solovyov

Ryazan State medical University

Author for correspondence.
Email: beerzombie@rambler.ru
ORCID iD: 0000-0001-8785-3628

Dr. Sci. (Med.), Professor

Russian Federation, 9 Vysokovol’tnaya str., Ryazan, 390026

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