Compromise of the kidney due to a trauma, blow or sudden deceleration.
Kidney trauma causes are manyfold (e.g. traffic accident, fortuitous falls, occupational accidents, blade and firearm injuries, sport accidents, etc).
It manifests with pain in the lumbar region, bruising, muscle spasm and blood in urine. If the fascia (layer) surrounding the kidney tears and ceases to contain the hematoma, the patient may show signs and symptoms of hypovolemic shock due to massive bleeding.
The diagnosis is reached through the collection of clinical history and several tests (i.e. blood tests, abdominal x-rays and ultrasound, CT-scan, intravenous pyelography and/or arteriography) to confirm the diagnosis.
Treatment will depend on the nature of the lesion: if there is a urine leak or collections of blood, they will be drained with percutaneous (through the skin) drains. Urgent surgery is performed in cases of kidney bursting and blade injuries will be operated on urgently.
- Michael S Runyon. Blunt genitourinary trauma: Initial evaluation and management. UpToDate Apr 20, 2015.
- Serafetinides E, Kitrey ND, Djakovic N, et al. Review of the current management of upper urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol 2015; 67:930.
- Siram SM, Gerald SZ, Greene WR, et al. Ureteral trauma: patterns and mechanisms of injury of an uncommon condition. Am J Surg 2010; 199:566.
- Gerstenbluth RE, Spirnak JP, Elder JS. Sports participation and high grade renal injuries in children. J Urol 2002; 168:2575.
- Sangthong B, Demetriades D, Martin M, et al. Management and hospital outcomes of blunt renal artery injuries: analysis of 517 patients from the National Trauma Data Bank. J Am Coll Surg 2006; 203:612.
- Fraser JD, Aguayo P, Ostlie DJ, St Peter SD. Review of the evidence on the management of blunt renal trauma in pediatric patients. Pediatr Surg Int 2009; 25:125.
