Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study
Introduction: The management of renal trauma includes operative and non operative approach based on clinical profile of patient. However, management of the high-grade renal trauma remains controversial. Aim: To evaluate mode of renal injury, staging and its management outcomes. Materials and M...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Pvt. Ltd.
2023-01-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
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| Online Access: | https://ijars.net/article_fulltext.aspx?issn=0973-709x&year=2023&month=January&volume=12&issue=1&page=SO01%20-%20SO04&id=2857 |
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| author | A Venkata Ranga Swamy D Raja Reddy Raja Sekhar Guddeti Mutyasri Pedapathnapu |
| author_facet | A Venkata Ranga Swamy D Raja Reddy Raja Sekhar Guddeti Mutyasri Pedapathnapu |
| author_sort | A Venkata Ranga Swamy |
| collection | DOAJ |
| description | Introduction: The management of renal trauma includes
operative and non operative approach based on clinical profile
of patient. However, management of the high-grade renal
trauma remains controversial.
Aim: To evaluate mode of renal injury, staging and its
management outcomes.
Materials and Methods: This prospective, observational study
included 49 patients (>15 years of age) who presented with
abdominal trauma. Computed tomography was performed for
grading of renal trauma. The patients were stratified based on
whether they underwent open renal surgery or conservative
management for their renal injury. Demographic characteristics
and a detailed history of renal injuries were recorded. The
patients were evaluated based on the rate of renal preservation
and complications at 6-month follow-up.
Results: The mean age was 32.10 years and majority of the
patients were males (87.76%). Blunt trauma (95.92%) was
most frequently reported. According to American Association
for the Surgery of Trauma (AAST), 8 (16.33%) patients were
categorized in grade I, 17 (34.69%) patients in grade II, 8
(16.33%) patients in grade III, 12 (24.49%) patients in grade
IV, and 4 (8.16%) patients in grade V. Microscopic haematuria
(42.86%) was the most common clinical presentation. The
majority of the patients were managed conservatively (89.8%).
Only two belonging to grade 4 and three from grade 5 were
managed operatively due to haemodynamic instability. Rib
fractures (n=10) were the most frequently associated injury,
and Urinary Tract Infection (UTI) (n=8) was the most common
complication, followed by persistent haematuria (n=3), and
hypertension (n=3). All patients with grades I to III showed
100% renal preservation rate with conservative management.
However, patients with grades IV and V showed renal
preservation rate of 83.33% and 50%, respectively.
Conclusion: Conservative treatment is a preferred choice of
treatment in the most of the renal trauma. The present study
reported high renal preservation rate in low-grade renal injuries,
which were managed conservatively. However, there is still
need of surgical treatment in high grade haemodynamically
unstable patients. |
| first_indexed | 2024-04-10T16:03:04Z |
| format | Article |
| id | doaj.art-df92cd5a39bf46f0bf4a6edb63c92cbb |
| institution | Directory Open Access Journal |
| issn | 2277-8543 2455-6874 |
| language | English |
| last_indexed | 2024-04-10T16:03:04Z |
| publishDate | 2023-01-01 |
| publisher | JCDR Research and Publications Pvt. Ltd. |
| record_format | Article |
| series | International Journal of Anatomy Radiology and Surgery |
| spelling | doaj.art-df92cd5a39bf46f0bf4a6edb63c92cbb2023-02-10T11:21:31ZengJCDR Research and Publications Pvt. Ltd.International Journal of Anatomy Radiology and Surgery2277-85432455-68742023-01-01121SO01SO0410.7860/IJARS/2023/57478.2857Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational StudyA Venkata Ranga Swamy0D Raja Reddy1Raja Sekhar Guddeti2Mutyasri Pedapathnapu3Assistant Professor, Department of Urology, Kurnool Medical College, Kurnool, Andhra Pradesh, India.Assistant Professor, Department of Urology, Kurnool Medical College, Kurnool, Andhra Pradesh, India.enior Resident, Department of Urology, Kurnool Medical College, Kurnool, Andhra Pradesh, India. Assistant Professor, Department of Urology, Kurnool Medical College, Kurnool, Andhra Pradesh, India. Introduction: The management of renal trauma includes operative and non operative approach based on clinical profile of patient. However, management of the high-grade renal trauma remains controversial. Aim: To evaluate mode of renal injury, staging and its management outcomes. Materials and Methods: This prospective, observational study included 49 patients (>15 years of age) who presented with abdominal trauma. Computed tomography was performed for grading of renal trauma. The patients were stratified based on whether they underwent open renal surgery or conservative management for their renal injury. Demographic characteristics and a detailed history of renal injuries were recorded. The patients were evaluated based on the rate of renal preservation and complications at 6-month follow-up. Results: The mean age was 32.10 years and majority of the patients were males (87.76%). Blunt trauma (95.92%) was most frequently reported. According to American Association for the Surgery of Trauma (AAST), 8 (16.33%) patients were categorized in grade I, 17 (34.69%) patients in grade II, 8 (16.33%) patients in grade III, 12 (24.49%) patients in grade IV, and 4 (8.16%) patients in grade V. Microscopic haematuria (42.86%) was the most common clinical presentation. The majority of the patients were managed conservatively (89.8%). Only two belonging to grade 4 and three from grade 5 were managed operatively due to haemodynamic instability. Rib fractures (n=10) were the most frequently associated injury, and Urinary Tract Infection (UTI) (n=8) was the most common complication, followed by persistent haematuria (n=3), and hypertension (n=3). All patients with grades I to III showed 100% renal preservation rate with conservative management. However, patients with grades IV and V showed renal preservation rate of 83.33% and 50%, respectively. Conclusion: Conservative treatment is a preferred choice of treatment in the most of the renal trauma. The present study reported high renal preservation rate in low-grade renal injuries, which were managed conservatively. However, there is still need of surgical treatment in high grade haemodynamically unstable patients.https://ijars.net/article_fulltext.aspx?issn=0973-709x&year=2023&month=January&volume=12&issue=1&page=SO01%20-%20SO04&id=2857complicationsconservativehaematuriahigh gradesurgical |
| spellingShingle | A Venkata Ranga Swamy D Raja Reddy Raja Sekhar Guddeti Mutyasri Pedapathnapu Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study International Journal of Anatomy Radiology and Surgery complications conservative haematuria high grade surgical |
| title | Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study |
| title_full | Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study |
| title_fullStr | Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study |
| title_full_unstemmed | Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study |
| title_short | Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study |
| title_sort | clinical characteristics and management of renal trauma a single centre observational study |
| topic | complications conservative haematuria high grade surgical |
| url | https://ijars.net/article_fulltext.aspx?issn=0973-709x&year=2023&month=January&volume=12&issue=1&page=SO01%20-%20SO04&id=2857 |
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