Sabir M, Babar A M.
Epidemiology and management of Renal Injuries.
Pak J Surg Jan ;18(2):17-20.

Objective. To study the epidemiology and management of renal injuries. Design: A prospective observational study. Place & Duration.: Department of Surgery, Quaid-e-Azam Medical College, Bahawal Victoria Hospital, Bahawalpur from January 1999 to April 2001. Subjects& Methods: All patients of renal injuries who presented during the study period were included in the study. They underwent history, examination and investigations. They were initially treated conservatively. In cases of persistent gross haematuria, shock, or associated abdominal visceral injury, operative treatment was contemplated. Results: A total of 46 patients were studied. Renal trauma was more common in 21-40 years age group (65%) and among males (78%). Blunt trauma (56.5%) caused by road traffic accidents (73%) was the most common cause, others being firearm (26%), stab (15%) and iatrogenic (2%) injuries. Right kidney was more commonly injured (63%) and 30% cases had associated visceral injuries. The two most common presentations were haematuria (93%) and flank pain (87%). The two most sensitive investigations were CT scan (100% sensitive) and urine microscopy (93% sensitive). Conservative treatment was done in 72% cases. Regarding operative treatment, total or partial nephrectomy was required in 31% cases each while in 38% patients renorrhaphy was done. Overall mortality was 6.5% and morbidity 11%, the most common complication being wound infection (4%). Conclusion: Renal trauma is more common in young males, mostly caused road traffic accidents. Expectant treatment is suitable in majority of the cases, especially for cases of blunt trauma.

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