Non-operative Management for High-grade Isolated Renal Trauma in Pediatric Patients: a Case Series

Overview

Journal Pan Afr Med J

Date 2023 May 9

PMID 37159632

Authors

Gede Wirya Diptanala Putra Duarsa

Paksi Satyagraha

Besut Daryanto

Affiliations

Soon will be listed here.

Abstract

The kidney is the most commonly injured urinary tract organ in pediatric trauma with blunt mechanisms, causing around 80% of cases. Non-operative management (NOM) remained the first choice for minor blunt renal trauma; however, its value for major trauma is still under debate. We present three children with high-grade isolated renal trauma diagnosed using computed tomography scans and treated using NOM as the main strategy of treatment. The first patient (12-year-old) fully recovered without needing an auxiliary procedure. The second patient (6-year-old) developed urinoma and underwent percutaneous drainage of urinoma and double J stent (DJ) with an uneventful result. The third patient (14-year-old) developed urinoma and underwent percutaneous drainage and DJ stent. However, he experienced continuous hematuria that was treated via super-selective embolization. In conclusion, NOM for isolated high-grade renal trauma is feasible with good outcomes. If complications were developed during follow-up, minimally invasive procedures, such as super-selective angioembolization in continuing hemorrhage and initial drainage in urinoma, offered a comparable outcome without needing open surgery.

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