Open AccessNonoperative Management of Blunt Renal Trauma
Author(s) -
Camila Issa Azevedo,
Amanda Baraldi de Souza,
Sizenando Vieira Starling,
Aparecida Andrade Ribeiro Franciscani,
Maria Helena Almeida Costa
Publication year - 2015
Publication title -
panamerican journal of trauma, critical care and emergency surgery
Language(s) - English
Resource type - Journals
ISSN - 2278-5388
DOI - 10.5005/jp-journals-10030-1108
Subject(s) - medicine , blunt , surgery , complication , nephrectomy , abdominal trauma , blunt trauma , mortality rate , renal injury , injury severity score , presentation (obstetrics) , trauma center , observational study , general surgery , retrospective cohort study , injury prevention , poison control , emergency medicine , kidney
Objective To analyze patients with blunt renal trauma who were managed conservatively, with emphasis on clinical presentation, grade of injury, complication and failure rates. Materials and methods A prospective observational study was conducted in Hospital João XXIII, between January and December 2013. Patients with blunt renal trauma and nonoperative management (NOM) were analyzed during this period. Data were collected in respect to: age, gender, mechanism of trauma, grade of injury, clinical presentation, revised trauma score (RTS), associated abdominal injuries, length of hospital stay and failure, complication and mortality rates. Results During this period, 27 patients with blunt renal trauma were suitable for nonoperative approach. The most common mechanisms of trauma were motor vehicle accidents (59.2%) and falls (22.2%) and the mean length of hospital stay was 10.5 days. The majority of the patients had grade II (48.1%) and III (29.6%) injuries, with mean RTS of 6.93. The complication rate was 3.7% and the mortality rate was 7.4%. All deaths were related to associated injuries. One patient with grade II injury required nephrectomy. This patient had concurrent injuries. Conclusion Blunt renal trauma can be successfully managed conservatively, with low complication rates. Nonoperative management is safe in stable patients and in environments with appropriated protocol for this approach. How to cite this article Franciscani AAR, Azevedo CI, Souza AB, Costa MHA, Starling SV, Drumond DAF. Nonoperative Management of Blunt Renal Trauma. Panam J Trauma Crit Care Emerg Surg 2015;4(1):6-10.