Renal trauma: a 5-year retrospective review in single institution

Syarif Syarif,Syakri Syahrir,Achmad M Palinrungi,Muhammad Asykar Palinrungi,Reinaldo Sunggiardi,Muhammad Faruk,Khoirul Kholis

doi:10.1186/s12301-020-00073-2

Abstract

BackgroundRenal trauma occurs in up to 5% of all trauma cases and accounts for 24% of abdominal solid organ injuries. Renal trauma management has evolved over the past decades, and current management is transitioning toward more conservative approaches for the majority of hemodynamically stable patients. The objective of this study was to analyze the mechanism of injury, management, and outcome in renal trauma.MethodsPatients diagnosed with renal trauma in Makassar, Indonesia, from January 2014 to December 2018 were identified retrospectively by the ICD-10 code. Data were collected from medical records. Imaging was classified by radiologists. Variables analyzed included age, sex, mechanism of injury, degree of renal trauma, related organ injury, management, and outcome.ResultsOut of the 68 patients identified, the average age was 23.9 ± 0.6 years, and most were male (83.8%). Blunt trauma accounted for 89.7% of all cases. The most common renal injuries were grade IV (42.6%), and 14% of the cases had no hematuria. Most patients were treated with non-operative management (NOM). Nephrectomy was performed in 16.2% of cases, and 5.9% of cases underwent renorrhaphy. It was found that 58.8% of cases had isolated renal trauma, and the overall mortality rate (2.9%) was due to related injuries.ConclusionsThe majority of blunt and penetrating renal trauma cases that are hemodynamically stable have a good outcome when treated with NOM. The presence of injury in other important organs both intra- and extra-abdominally aggravates the patient’s condition and affects the prognosis.

Highlights

Renal trauma occurs in up to 5% of all trauma cases and accounts for 24% of abdominal solid organ injuries
Many blunt renal traumas are in the low-grade classification, and 80–85% of these cases can be treated with non-operative management (NOM) [11]
2 Methods We looked at the characteristics and descriptions of renal trauma cases in Makassar, Indonesia, for the 5 years from January 2014 to December 2018

Summary

Introduction

Renal trauma occurs in up to 5% of all trauma cases and accounts for 24% of abdominal solid organ injuries. The objective of this study was to analyze the mechanism of injury, management, and outcome in renal trauma. The incidence of renal trauma is around 245,000 cases each year worldwide [3, 4]. Blunt trauma to the abdomen, flank, or back is the most common mechanism of injury [1]. Blunt trauma is reported to be the cause of the majority of cases (80–95% of all renal trauma) and mostly occurs due to traffic accidents [6, 11]. Many blunt renal traumas are in the low-grade classification, and 80–85% of these cases can be treated with non-operative management (NOM) [11].

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