[Diagnostic attitude in a patient with kidney trauma].
OBJECTIVE
Our aim was to assess our results in the management of renal trauma patients.


METHODS
A retrospective review of medical charts from 1989 to 1997 was carried out.


RESULTS
Twenty-seven cases involving 27 kidneys were treated during the study period, with 16 grade II injuries, 8 grade II and 3 grade III. Ultrasound was the most used diagnostic tool, followed by computerized tomography (CT) and intravenous pyelography (IVP). Falls and traffic accidents were the main etiologic agents (48 and 41%, respectively). Eight out of 11 patients with grade II/III injuries received surgical treatment. Three cases required early surgery immediately after arrival and 5 cases had planned surgery. After a mean follow-up period of 16 months, renal function has remained above 40% in all patients, excluding 3 cases treated with partial nephrectomy.


CONCLUSIONS
A conservative attitude is of choice in children with renal trauma. CT is the main diagnostic tool except in patients suspected of isolated grade I injury. Ultrasound followed by IVP is a valid choice for these cases and especially helpful for preschool patients which require general anesthesia for CT exploration.
Ibáñez Pradas
V
V
Departamento de Cirugía Pediátrica, Hospital Infantil La Fe, Valencia.
Serrano Durbá
A
A
Domínguez Hinarejos
C
C
Estornell Moragues
F
F
Reig Ruiz
C
C
Martínez Verdú
M
M
García Ibarra
F
F
D000058:Accidental Falls; D000063:Accidents, Traffic; D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007668:Kidney / Q000293:injuries* / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014567:Urography; D014947:Wounds and Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery