A prospective observational study on the optimal management approach based on the clinical profile of renal trauma patients

Abstract

Introduction: The kidney is the most commonly injured genitourinary organ following trauma. It can be a result of both blunt and penetrating trauma to the abdomen. Both conservative and surgical managements are employed as per the clinical profile of the patient.Methods: This prospective observational study included all the patients with renal trauma who presented at the ER. Computed tomography (CT) was done for grading of renal trauma.Results: A total of 60 patients were included in the study. Eighty percent (n=48) patients were managed conservatively. Twenty percent (n=12) patients underwent some form of surgical management. The mean (SD) hospital stay as 11.38 (6.94) days. Twenty-eight patients (46.67%) had right renal injury. Thirty-two patients (53.33%) had left renal involvement. There were no patients with bilateral renal injury. According to American association for the surgery of trauma (AAST), 11.66% patients (n=7) were categorised in grade I, 20% patients (n=12) to grade II, 33.33% patients (n=20) to grade III, 25% patients (n=15) to grade IV and 10% patients (n=6) to grade V. The most common associated injuries were rib fracture and visceral injury.Conclusion: Much has changed since historical times with regards to renal trauma management. Data from various studies point towards a paradigm shift from surgical to conservative management as the standard of care irrespective of the grade and mode of renal trauma.