Renal Injury Study notes for Exam

Renal inury study notes 300x225

Renal Trauma or RENAL Injury Study notes for Exam

Renal trauma is due to-

  • Minor injuries- blunt trauma (RTA, falls, assaults & sporting injuries)
  • Major injuries – penetrating trauma (knife or gunshot wounds)
    • Blunt trauma is much more common than penetrating trauma.

Clinical features of RENAL Injury

  • abdominal pain especially Loin Pain which inscrease on Movements
  • Hematuria is the most important sign of renal injury.
  • Loin bulge due to perinephric haemtoma.
  • Bruising of soft tissue in the loin.
  •  abdominal distension.–>in case of Retroperitoneal haematoma
  • systolic blood pressure ≤90 mmHg

AAST Renal Injury Classification 

1. Grade I-Renal Injury

  • Contusion or non-enlarging subcapsular perirenal haematoma, and no laceration.

2. Grade II-Renal Injury

  • Superficial laceration

3. Grade III-Renal Injury

  • Laceration >1 cm without extension into the renal pelvis or collecting system (no evidence of urine extravasation).

4. Grade IV-Renal Injury

  • Laceration extends to renal pelvis or urinary exrravasatlon.
  • Vascular: injury to main renal artery or vein with contained haemorrhage.
  • Segmental infarctions without associated lacerations.
  • Expanding subcapsular haematomas compressing the kidney.

5. Grade V-Renal Injury

  • Shattered kidney.
  • Avulsion of renal hilum: devascularisation of a kidney due to hilar injury.
  • Ureteropelvicavulsions.
  • Complete laceration or thrombus of the main renal artery or vein.

Renal Injury Study notes for Exam

 

Investigations for Renal Injury

  1. Intravenous pyelography (IVP) can shows (An IVP is done urgently to assesss the damage to the kidney and to know the functioning of the other kidney)-
  • Intrarenal extravasation
  • Extrarenal extravasation
  • Function of injured kidney

2. CT scan with contrast is the Investigation of Choice

3. USG

Treatment-

  • Blunt trauma are treated conservatively
  • Penetrating injuries, small & major lacerations- Emergency surgical exploration.

 

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