Abdominal Tumors In Children Research Articles

The synergistic effects of anoikis-related genes and EMT-related genes in the prognostic prediction of Wilms tumor.

Wilms tumor (WT) is the most common type of malignant abdominal tumor in children; it exhibits a high degree of malignancy, grow rapidly, and is prone to metastasis. This study aimed to construct a prognosis model based on anoikis-related genes (ARGs) and epithelial-mesenchymal transition (EMT)-related genes (ERGs) for WT patients; we assessed the characteristics of the tumor microenvironment and treatment efficacy, as well as identifying potential therapeutic targets. To this end, we downloaded transcriptome sequencing data and clinical data for WT and normal renal cortices and used R to construct and validate the prognostic model based on ARGs and ERGs. Additionally, we performed clinical feature analysis, nomogram construction, mutation analysis, drug sensitivity analysis, Connectivity Map (cMAP) analysis, functional enrichment analysis, and immune infiltration analysis. Finally, we screened the hub gene using the STRING database and validated it via experiments. In this way, we constructed a model with good accuracy and robustness, which was composed of seven anoikis- and EMT-related genes. Paclitaxel and mesna were selected as potential chemotherapeutic drugs and adjuvant chemotherapeutic drugs for the WT high-risk group by using the Genomics of Drug Sensitivity in Cancer (GDSC) and cMAP compound libraries, respectively. We proved the existence of a strong correlation between invasive immune cells and prognostic genes and risk scores. Next, we selected NTRK2 as the hub gene, and in vitro experiments confirmed that its inhibition can significantly inhibit the proliferation and migration of tumor cells and promote late apoptosis. In summary, we screened out the potential biomarkers and chemotherapeutic drugs that can improve the prognosis of patients with WT.

Multiphase enhanced CT-based transformer for differential diagnosis and predicting surgical risk events of solid abdominal tumors in children

BackgroundFor pediatric patients with solid abdominal tumors, early diagnosis can guide clinical treatment decisions, and comprehensive preoperative evaluation is essential to reduce surgical risk. The aim of this study was to explore the feasibility of multiphase enhanced CT-based transformer in the early diagnosis of tumors and prediction of surgical risk events (SRE). MethodsA total of 496 pediatric patients with solid abdominal tumors were enrolled in the study. With Swin transformer, we constructed and trained two Swin-T models based on preoperative multiphase enhanced CT for personalized prediction of tumor type and SRE status. Subsequently, we comprehensively evaluated the performance of each model and constructed four benchmark models for performance comparison. ResultsThere was no significant difference in SRE status between tumor types. In the diagnostic task, areas under the receiver operating characteristic curves (AUC) of the Swin-T model were 0.987 (95 % CI, 0.973–0.997) and 0.844 (95 % CI, 0.730–0.940) in the training and validation cohorts, respectively. In predicting SRE, AUCs of the Swin-T model were 0.920 (95 % CI, 0.885–0.948) and 0.741 (95 % CI, 0.632–0.838) in the training and test cohorts, respectively. The Swin-T model achieved the best performance in both classification tasks compared to benchmark models. ConclusionThe Swin-T model is a promising tool to assist pediatricians in the differential diagnosis of abdominal tumors and in comprehensive preoperative evaluation.

Enhancing surgical planning for abdominal tumors in children through advanced 3D visualization techniques: a systematic review of future prospects.

Preoperative three-dimensional (3D) reconstruction using sectional imaging is increasingly used in challenging pediatric cases to aid in surgical planning. Many case series have described various teams' experiences, discussing feasibility and realism, while emphasizing the technological potential for children. Nonetheless, general knowledge on this topic remains limited compared to the broader research landscape. The aim of this review was to explore the current devices and new opportunities provided by preoperative Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI). A systematic review was conducted to screen pediatric cases of abdominal and pelvic tumors with preoperative 3D reconstruction published between 2000 and 2023. Surgical planning was facilitated through virtual reconstruction or 3D printing. Virtual reconstruction of complex tumors enables precise delineation of solid masses, formulation of dissection plans, and suggests dedicated vessel ligation, optimizing tissue preservation. Vascular mapping is particularly relevant for liver surgery, large neuroblastoma with imaging-defined risk factors (IDRFs), and tumors encasing major vessels, such as complex median retroperitoneal malignant masses. 3D printing can facilitate specific tissue preservation, now accessible with minimally invasive procedures like partial nephrectomy. The latest advancements enable neural plexus reconstruction to guide surgical nerve sparing, for example, hypogastric nerve modelling, typically adjacent to large pelvic tumors. New insights will soon incorporate nerve plexus images into anatomical segmentation reconstructions, facilitated by non-irradiating imaging modalities like MRI. Although not yet published in pediatric surgical procedures, the next anticipated advancement is augmented reality, enhancing real-time intraoperative guidance: the surgeon will use a robotic console overlaying functional and anatomical data onto a magnified surgical field, enhancing robotic precision in confined spaces.

Abdominal Mass Revealing a Right Ovarian Cyst in a 2-Year-Old Infant: A Case Report

Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple; the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.

Abdominal tumors in children: A comprehensive study on the diagnosis, management, and clinical outcome of pediatric patients with lymphoma in Kashmir

Background: Although primary abdominal tumors are rare but their diagnosis, high-cost treatment and psychological instability among both patients and parents are challenging. There are several types of abdominal tumors in pediatric age group which include neuroblastoma, Wilm’s tumor, hepatoblastoma, lymphomas, soft-tissue sarcomas, and germ cell tumors. Aims and Objectives: The present study was objectively conducted to identify Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) tumors among all patients presented with abdominal tumors. In addition to this, histopatological profile, clinical profile and disease prognosis among such patients has also been analyzed. Materials and Methods: A total of 64 pediatric patients presented with primary abdominal tumors were included in the study but only 20 patients with lymphoma were identified. The study was conducted at the Department of Pediatric Division, SMHS Hospital Srinagar with effect from 2005 to 2008. Results: The Majority of NHL patients were found to have Stage II and Stage IV. Moreover, all the four cases of Hodkins lymphoma had Stage IV. Out of the 20 patients with lymphoma six died, of them five had NHL and one patient had HL, thus placing the overall survival rate as 70%. Conclusion: The present study demonstrated that both NHL and HL tumors may develop to advanced stage and even patient may die if the timely diagnosis and proper management is not there. We recommend collective team work of medicos from various departments for the precise diagnosis and optimal management of such patients.

Making good use of ultrasound for abdominal tumors in children

Making good use of ultrasound for abdominal tumors in children

A comparison between ultrasonography and single-phase computed tomography for preoperative assessment of solid abdominal tumors in children

ObjectiveThis study aimed to estimate the performance of single-phase-enhanced computed tomography and ultrasonography examinations in the preoperative evaluation of solid abdominal tumors and their relationship with relevant adjacent structures in children. MethodsThis retrospective study included 50 pediatric patients with malignant solid abdominal tumors treated with surgical resection between 2009-2017. Preoperative computed tomography and ultrasonography were compared to operative findings (gold standard) in the diagnosis of invasion or encasement of adjacent structures. Accuracy, sensitivity, specificity, and positive and negative predictive values were evaluated. ResultsRenal (20.4%) and neuroblastic (19.4%) tumors were the most common. Complete surgical resection with negative margins was achieved in 44 (88%) patients. The comparison between single-phase-enhanced computed tomography and ultrasonography findings showed the following results: sensitivity = 90.3% vs 86.6%, specificity = 86.8% vs 94.6%, negative predictive value = 95.3% vs 94.4%, positive predictive value = 75.3% vs 86.9%, and accuracy = 87.9% vs 92.2%. The correlation (kappa index) between computed tomography and ultrasonography examinations was 0.72 (p < 0.001). In 14% (7/50) of the patients, the invasion of adjacent structures was diagnosed by ultrasonography but not by computed tomography (1 patient had 2 invaded structures). ConclusionUltrasonography can be considered a complementary method to single-phase-enhanced computed tomography in the preoperative evaluation of children with an abdominal tumor. The present study showed that ultrasonography and single-phase-enhanced computed tomography each possess a high accuracy in the preoperative planning of resection of solid abdominal tumors in children. Thus, it seems that the combination of both imaging methods would be enough for the evaluation of most abdominal tumors in the pediatric population.

Informe estructurado en tumores abdominales pediátricos: neuroblastoma y nefroblastoma

The structured radiology report is the main means through which radiologists communicate with clinicians. The implementation of structured reports for the most common abdominal tumors in children (neuroblastoma and nephroblastoma) has been made easier by international pediatric oncology societies’ development of protocols that promote the use of standardized terms, establish consensuses about the imaging techniques and findings, and facilitate data storage to enable their centralized review.We present the structured reports for the two most common abdominal tumors in children: neuroblastoma and nephroblastoma.

The Emerging Landscape of Long Non-Coding RNAs in Wilms Tumor.

Long noncoding RNAs (LncRNAs) are transcripts of nucleic acid sequences with a length of more than 200 bp, which have only partial coding capabilities. Recent studies have shown that lncRNAs located in the nucleus or cytoplasm can be used as gene expression regulatory elements due to their important regulatory effects in a variety of biological processes. Wilms tumor (WT) is a common abdominal tumor in children whose pathogenesis remains unclear. In recent years, many specifically expressed lncRNAs have been found in WT, which affect the occurrence and development of WT. At the same time, lncRNAs may have the capacity to become novel biomarkers for the diagnosis and prognosis of WT. This article reviews related research progress on the relationship between lncRNAs and WT, to provide a new direction for clinical diagnosis and treatment of WT.

Risk stratification of abdominal tumors in children with amide proton transfer imaging.

To evaluate the potential of molecular amide proton transfer (APT) MRI for predicting the risk group of abdominal tumors in children, and compare it with quantitative T1 and T2 mapping. This prospective study enrolled 133 untreated pediatric patients with suspected abdominal tumors from February 2019 to September 2020. APT-weighted (APTw) imaging and quantitative relaxation time mapping sequences were executed for each subject. The region of interest (ROI) was generated with automatic artifact detection and ROI-shrinking algorithms, within which the APTw, T1, and T2 indices were calculated and compared between different risk groups. The prediction performance of different imaging parameters was assessed with the receiver operating characteristics (ROC) analysis and Student's t-test. Fifty-seven patients were included in the final analysis, including 24 neuroblastomas (NB), 18 Wilms' tumors (WT), and 15 hepatoblastomas (HB). The APTw signal was significantly (p < .001) higher in patients with high-risk NB than those with low-risk NB, while the difference between patients with low-risk and high-risk WT (p = .69) or HB (p = .35) was not statistically significant. The associated areas under the curve (AUC) for APT to differentiate low-risk and high-risk NB, WT, and HB were 0.93, 0.58, and 0.71, respectively. The quantitative T1 and T2 values generated AUCs of 0.61-0.70 for the risk stratification of abdominal tumors. APT MRI is a potential imaging biomarker for stratifying the risk group of pediatric neuroblastoma in the abdomen preoperatively and provides added value to structural MRI. • Amide proton transfer (APT) imaging showed significantly (p < .001) higher values in pediatric patients with high-risk neuroblastoma than those with low-risk neuroblastoma, but did not demonstrate a significant difference in patients with Wilms' tumor (p = .69) or hepatoblastoma (p = .35). • The associated areas under the curve (AUC) for APT to differentiate low-risk and high-risk neuroblastoma, Wilms' tumor, and hepatoblastoma were 0.93, 0.58, and 0.71, respectively. • The quantitative T1 and T2 indices generated AUCs of 0.61-0.70 for dichotomizing the risk group of abdominal tumors.

Pediatric Primary Hepatic Tumors: Diagnostic Considerations.

The liver is the third most common site of abdominal tumors in children. This review article aims to summarize current evidence surrounding identification and diagnosis of primary hepatic tumors in the pediatric population based upon clinical presentation, epidemiology, and risk factors as well as classical imaging, histopathological, and molecular diagnostic findings. Readers will be able to recognize the features and distinguish between benign and malignant hepatic tumors within different age groups.

Clinico-Pathological Profile of Malignant Abdominal Tumors in Children: Experience of the Pediatric Oncology Unit in Bamako

Introduction: the objective was to describe the epidemiological and histological aspects of malignant abdominal tumors in children. Methodology: This was a descriptive, cross-sectional study conducted from January 1, 2017 to December 31, 2018. We included all patients aged 0 to 15 years with histologically confirmed abdominal malignancies. Results: We collected 46 files of malignant tumors of the abdomen (35% of pediatric cancers). The majority of patients were under 5 years old (65%). The sex ratio was 1.7. They were generally from disadvantaged socio-economic backgrounds (67%). The average consultation time was 50 days. The main reasons for consultation were abdominal mass (48%), pain (17%) or distension (9%). The mass was large, hard (89%), immobile (71%) and painful (46%). Malnutrition was found in 80% of patients. The mass was retro-peritoneal in 63% of cases and renal in 54%. It was solid in 94% of cases and heterogeneous in 76% of cases. The assay for tumor markers was not performed. Anemia was present in all patients. Fine needle aspiration was performed in 43%, biopsy in 37% and myelogram in 15% of cases. spinal cord involvement was observed in 28% of Burkitt’s cases. The main cancers diagnosed were nephroblastoma (52%), Burkitt’s lymphoma (26%) and neuroblastoma (13%). Stage 1 and stage 2 were frequent in 20% and 22% of cases, respectively; 36% of cases were not staged. The average duration of chemotherapy was 11 weeks. Total resection was performed in 30% of cases. The outcome of the patients was marked by total remission in 65%. Conclusion: Abdominal malignancies are very common in children. The diagnosis of certainty is late in our context.

Abdominal tumor syndrome in children

This article deals with the actual problem of the syndrome of abdominal tumor in children. A complex of clinical symptoms and signs is described that characterize the presence of a tumor-like formation in the abdominal cavity of various origins. The various causes of the occurrence of volumetric processes in the abdominal cavity are examined. Considering that the volumetric process in the abdominal cavity in children is a common situation, and it occurs not only with true tumors, the article describes various clinical situations that lead to the syndrome of abdominal tumor in children.

Study on clinical profile and management of abdominal tumours in children

Background: The discovery of an abdominal mass in a child usually presents a challenging problem in the diagnosis and treatment to the paediatrician, surgeon and urologist. Because of the heterogenicity of the lesion knowledge of differential of a mass in abdomen is essential for the logical evaluation of a child.Methods: The present study comprises of 25 children who presented with an intra-abdominal mass were included. The medical causes of the abdominal masses i.e. hepatosplenomegaly and leukemias were excluded. All patients admitted were routine investigated and whichever necessary. After the diagnosis, surgery was done wherever indicated and post-operatively the diagnosis was confirmed after the histopathological report.Results: All the cases presented with mass in abdomen while the other presentations were pain in abdomen (36%), fever (20%) and haematuria and vomiting (16% each). It was found that 64% of the masses were urological in origin while 36% of the masses were non-urological in origin. 21 (84%) patients underwent surgery, 10 (40%) patients took chemotherapy, 9 (36%) patients took radiotherapy.Conclusions: Routine investigations were only helpful in diagnosing the infection in infecting cases. Most reliable specific investigation was intravenous pyelography. It was found that majority of the abdominal masses in children were arising from urinary system. Correlation between pre-operative and post-operative diagnosis was found almost consistent.

Two rare cases of abdominal tumor in children: Answers.

Two rare cases of abdominal tumor in children: Answers.

Spectrum of Childhood and Adolescent Ovarian Tumors in India: 25 Years Experience at a Single Institution.

BACKGROUND:Ovarian tumour in children and adolescent girls form an uncommon but important part of gynaecological malignancies. They account for 1% of all the childhood malignancies and 8% of all abdominal tumours in children. Since the ovarian cysts are thought to arise from mature follicles, these tumours were considered to be infrequent in the paediatric population.AIM:The rarity of this condition prompted us to conduct this study and share our experience on the incidence and clinicopathological features of different ovarian tumours in girls up to 20 years of age observed in last 25 years at a single tertiary care hospital.MATERIAL AND METHODS:This was a retrospective study conducted in the Department of Pathology at a tertiary hospital, Delhi. All ovarian tumours up to the age of 20 years in the past 25 years (1990-2014) were included for the purpose of studying the clinicopathological aspects of ovarian tumours in this age group. Descriptive statistics for prevalence and age-wise prevalence was done. Chi-square test, to find an association between the age, laterality and size with malignancy was performed.RESULTS:We received a total of 1102 cases of ovarian tumours over the period of 25 years (1990 to 2014), of which 112 (10%) cases were seen in girls up to 20 years of age. The mean age of the patients was 15.3 ± 4 years. The most common presenting complaint was pain abdomen (46.4 %) There was a statistically significant correlation found between size and malignancy status of tumours in our study (p = 0.00). Of 112 cases of ovarian tumours, 39/112 (34.8%) were malignant and 73/112 (65.2%) were benign. Mature cystic teratoma (27.6%) was the most common type of benign tumour in this age group and immature teratomas were the most common type of malignant ovarian neoplasms.CONCLUSION:Premenarchal girls with ovarian masses may have varied presentations. Abdominal pain is the most common presenting complaint of young adolescent girls with adnexal masses. So the index of suspicion should be kept high and prompt investigations like ultrasound must be performed early to rule out such adnexal masses. Immature Teratoma was the most common malignant and mature cystic teratoma was the most common benign tumour in our study.

Neoplasms, as one of the causes of the syndrome of palpable abdominal tumor in children

Syndrome of palpable abdominal tumor in children is a difficult diagnostic problem. The difficulties associate with many disease entities that underlie this syndrome, often erased clinical picture and late referral to a doctor. In this article we will try to clarify the problems of diagnosis and treatment of exactly oncological diseases, as a cause of the syndrome palpable abdominal tumor. The vast majority of patients with complaints palpable education seek medical care to pediatricians or general practitioners. Prolongation of the diagnosis is often and directly associate with two factors: low oncological alertness by pediatricians (rarely by Pediatric Surgeons) and the lack of attention of parents to the initial manifestations of tumor in children. We have tried to describe the most characteristic symptoms inherent in the majority of tumors localized in the abdomen, the pelvis and the retroperitoneal space. Also there is information about on laboratory and instrumental methods of research used in the diagnosis of tumors, side by side the “routine” methods such as the complete blood count, abdominal ultrasound, in some cases, determination of specific tumor markers. There are the results of the comparative analysis and distinctive features of benign and malignant tumors of this localization are highlighted. Also the basic principles of the treatment of solid tumors in children are presented in this article. The article is focused primarily on all pediatricians, pediatric surgeons and general practitioners.

Imaging spectrum of primary malignant renal neoplasms in children

Wilms’ tumor (WT) is the most common abdominal tumor in children. Many pediatric renal tumors in the past were categorized as WT; however, in recent years, several specific renal tumors have been recognized as distinct pathological entities. The age and clinical presentation of the child and distinctive imaging features may help in reaching a specific diagnosis in most cases. This is important as it has implications on the pre-operative diagnostic work-up and prognosis of the child. However, it is often not possible to differentiate one from the other pediatric renal tumor on the basis of imaging alone, and the final diagnosis is often made at histological examination of the surgical specimen. This article reviews the imaging features of primary malignant renal neoplasms in children along with their clinical presentation and pathological features.

Contribution and Limits of Power and Triplex Doppler Ultrasound in the Diagnosis of Abdominal Tumours in Children

PurposeImportant achievements have been obtained in paediatric oncology in the last period of time in the domain of diagnosis and therapy. To obtain a good evolution in a malign process on a child, it is very important to diagnose it in an early stage.Material & MethodsWe reported a prospective study over a period of 5 years with 30 children with abdominal tumours which had been proven to be malignant. As an initial diagnostic method the power and triplex ultrasound was the principal investigation and this proves its importance for screenings in paediatry. Colour Doppler with contrast enhancing substance was also used. Access to investigations based on images, alongside with biological markers and biopsy, was useful to make a diagnosis correctly and quickly.ResultsIf the abdominal tumour is solid, there is a suspicion of a malign tumour and then CT and MRI are necessary. Ultrasound allowed us, to appreciate tumour vascularization at the level of malign tumour formations, through the presence of neoformations, in the periphery as well as in the interior of the nodule and also the differentiation of these from the zones of necrosis and intratumoral haemorrhage. Hepatic tumours occupy the 3rd position in frequency with children, after nephroblastoma and neuroblastoma.ConclusionDoppler ultrasound permits the identification of vessel neoformations, of necrosis and of malign tumour calcifications as well as the identification of echostructure and local invasion elements which sustain its malign character. PurposeImportant achievements have been obtained in paediatric oncology in the last period of time in the domain of diagnosis and therapy. To obtain a good evolution in a malign process on a child, it is very important to diagnose it in an early stage. Important achievements have been obtained in paediatric oncology in the last period of time in the domain of diagnosis and therapy. To obtain a good evolution in a malign process on a child, it is very important to diagnose it in an early stage. Material & MethodsWe reported a prospective study over a period of 5 years with 30 children with abdominal tumours which had been proven to be malignant. As an initial diagnostic method the power and triplex ultrasound was the principal investigation and this proves its importance for screenings in paediatry. Colour Doppler with contrast enhancing substance was also used. Access to investigations based on images, alongside with biological markers and biopsy, was useful to make a diagnosis correctly and quickly. We reported a prospective study over a period of 5 years with 30 children with abdominal tumours which had been proven to be malignant. As an initial diagnostic method the power and triplex ultrasound was the principal investigation and this proves its importance for screenings in paediatry. Colour Doppler with contrast enhancing substance was also used. Access to investigations based on images, alongside with biological markers and biopsy, was useful to make a diagnosis correctly and quickly. ResultsIf the abdominal tumour is solid, there is a suspicion of a malign tumour and then CT and MRI are necessary. Ultrasound allowed us, to appreciate tumour vascularization at the level of malign tumour formations, through the presence of neoformations, in the periphery as well as in the interior of the nodule and also the differentiation of these from the zones of necrosis and intratumoral haemorrhage. Hepatic tumours occupy the 3rd position in frequency with children, after nephroblastoma and neuroblastoma. If the abdominal tumour is solid, there is a suspicion of a malign tumour and then CT and MRI are necessary. Ultrasound allowed us, to appreciate tumour vascularization at the level of malign tumour formations, through the presence of neoformations, in the periphery as well as in the interior of the nodule and also the differentiation of these from the zones of necrosis and intratumoral haemorrhage. Hepatic tumours occupy the 3rd position in frequency with children, after nephroblastoma and neuroblastoma. ConclusionDoppler ultrasound permits the identification of vessel neoformations, of necrosis and of malign tumour calcifications as well as the identification of echostructure and local invasion elements which sustain its malign character. Doppler ultrasound permits the identification of vessel neoformations, of necrosis and of malign tumour calcifications as well as the identification of echostructure and local invasion elements which sustain its malign character.

Instituting a Conservative Management Protocol for Pediatric Blunt Renal Trauma: Evaluation of a Prospectively Maintained Patient Registry

Retrospective studies show that even high grade pediatric renal trauma can be safely managed conservatively. We evaluated a prospective patient registry at our level 1 pediatric trauma center, where patients with renal trauma were treated with an institutional review board approved conservative blunt renal trauma protocol. Standardized treatment included a trial of expectant management for all stable cases. We identified 39 children with blunt renal trauma treated between 2003 and 2008. A strict conservative approach was used, ie nonoperative management in cases that were hemodynamically stable or had a favorable response with up to 2 units of blood transfused and no operative renal lesion on imaging. Adult imaging protocols were followed and exploratory laparotomy for nonrenal causes did not alter course of expectant renal management. Outcomes evaluated were injury grade, hematuria, operative management, length of stay and associated injuries. Based on the American Association for the Surgery of Trauma organ injury severity scale, 13 patients were considered to have grade I disease, 8 grade II, 11 grade III, 6 grade IV and 1 grade V. Conservative management resulted in a 97% nonoperative rate and a single renorrhaphy. Using a prospective patient registry, this study demonstrates that conservative treatment of blunt pediatric renal trauma is safe and effective. Also, serious renal injuries are not missed by applying adult diagnostic imaging protocols in children.