Blunt renal trauma in children with previously undiagnosed pre-existing renal lesions and guidelines for effective initial management of kidney injury

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dc.contributor.authorÖnen, A
dc.contributor.authorKaya, M
dc.contributor.authorCigdem, MK
dc.contributor.authorOtçu, S
dc.contributor.authorÖztürk, H
dc.contributor.authorDokucu, AI
dc.date.accessioned2024-04-24T16:24:06Z
dc.date.available2024-04-24T16:24:06Z
dc.date.issued2002
dc.departmentDicle Üniversitesien_US
dc.description.abstractObjectives To record pre-existing renal lesions (PERL) found incidentally during evaluation for blunt renal trauma in children. determine their importance. suggest guidelines for the effective initial management of children with significant renal trauma and to evaluate the role of temporary percutaneous nephrostomy tube drainage (TPND) in these patients. Patients and methods We reviewed 338 children who were hospitalized with blunt abdominal trauma between 1992 and 2000. Thirty-one patients had significant renal injury, 17 before 1997 (reviewed retrospectively) and the others reviewed and followed prospectively. Results Eleven of the 31 children had a PERL. which had been undiagnosed before the injury. The mean (range) follow-up was 52 (15-104) months. There were 22 boys and nine girls (mean age 9.1 years, range 2-13). The mean age was lower in patients with a PERL than in children with isolated renal injury. The most common cause of blunt renal injuries was a fall (45%) followed by motor vehicle accidents. Renal stones were present in five children, pelvi-ureteric junction obstruction in four, megaureter in one and a renal cyst in one. The mean injury severity scores were 12 in the children with a PERL and 14 in patients without. TPND was used in seven (22%) children: four were associated with a PERL. The mean grade of injury score for the kidney was higher in patients with a PERL and in children who underwent TPND than in patients who previously had a normal kidney and in children who did not undergo TPND. Early surgical intervention was required in three children; all were associated with a PERL. Of the 13 children who underwent surgery 11 had previous disease. Conclusions The frequency of PERL is high (36%) in children with blunt renal trauma. PERL can predispose minor trauma to cause kidney injury even with no evidence of hydronephrosis. When a minor trauma results in renal injury, it is important to seek a PERL. In selected patients. TPND may decrease the length of hospital stay and improve the outcome of the injured kidney. thereby decreasing the need for further surgery in those with isolated renal injury: however, it appears not to decrease the need for later operations in children with a PERL.en_US
dc.identifier.doi10.1046/j.1464-410X.2002.02787.x
dc.identifier.endpage941en_US
dc.identifier.issn1464-4096
dc.identifier.issn1464-410X
dc.identifier.issue9en_US
dc.identifier.pmid12010244
dc.identifier.scopus2-s2.0-0036096490
dc.identifier.scopusqualityQ1
dc.identifier.startpage936en_US
dc.identifier.urihttps://doi.org/10.1046/j.1464-410X.2002.02787.x
dc.identifier.urihttps://hdl.handle.net/11468/16495
dc.identifier.volume89en_US
dc.identifier.wosWOS:000176083300022
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofBju International
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectPre-Existing Renal Lesionen_US
dc.subjectBlunt Renal Traumaen_US
dc.subjectChildrenen_US
dc.subjectNephrostomyen_US
dc.titleBlunt renal trauma in children with previously undiagnosed pre-existing renal lesions and guidelines for effective initial management of kidney injuryen_US
dc.titleBlunt renal trauma in children with previously undiagnosed pre-existing renal lesions and guidelines for effective initial management of kidney injury
dc.typeArticleen_US

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