Management of renal injuries in blunt abdominal trauma

Background: Renal trauma occurs in 8% to 10% of all patients with abdominal trauma & the most common organ injured in pediatrics blunt abdominal trauma. Blunt force is responsible for 70 to 80% of renal trauma. Objectives: To identify & determine the common mode & types of injury, investigation of choice, conservative & surgical management & outcome. Methods: An Observational Cross Sectional Combined Retrospective and Prospective study of 25 patients of blunt renal injuries was conducted during a period of 5 years from December 2008 to November 2013. Results: Blunt renal injury is more common in young male of 11-20 years (40% patients). Road traffic accident was responsible for 64% cases. Minor & major renal injuries were found in 68% & 32% cases respectively. CT scan & USG had detected renal injuries in 88 % & 64% patients respectively. Only 2 (8%) patients of blunt renal trauma were managed surgically, both the patient had AAST Grade IV injury. All 17 (68%) patients with AAST Grade I, II & III were successfully managed conservatively with one mortality. Conclusion: Contrast enhanced computerized tomography abdomen is the choice of investigation. Majority of patients had minor renal injuries (Grade I, II or III) with Grade V injury being the most rare and most severe renal injury.