Retrospective analysis of 135 renal trauma cases.
BACKGROUND
We review our trauma cases over the last 11 years and discuss our diagnosis and treatment modalities.


METHODS
One hundred and thirty-five patients with renal injuries who had been hospitalized in the Urology and General Surgery clinics of Dicle University hospital between 1990 and 2001 were reviewed retrospectively. Patients were evaluated with regard to age, sex, cause of trauma, transport time, diagnostic methods, grade of injuries, associated organ injuries, treatments and complications.


RESULTS
One hundred and forty-one renal injuries were established in 135 patients. The patients were between 5 and 65 years old; 114 (84.4%) were male and 21 (15.6%) were female. The most common cause of injuries (99 patients) was penetrating injuries. The transport time to hospital after injury was approximately 116 min. Immediate laparotomy was performed in 95 hemodynamically unstable patients. Radiological investigations were carried out in the remaining 40 patients. Most of the injuries were grade 4 (28, 19.86%) or 5 (60, 42.55%). Isolated renal injury was established in only 22 of 135 patients. Nephrorrhaphy was performed in 45 of 141 kidneys. Twelve injured kidneys were managed conservatively. Nephrectomy was performed in 66 of 141 kidneys. The remaining injured kidneys were managed with different treatment methods. Twenty-nine (21.48%) patients were lost intraoperatively or during the early postoperative period.


CONCLUSIONS
We believe that our rates of nephrectomy and mortality were high because of the long transport time, unsuitable transport type, frequent high grade and high rate of associated organ injuries.
Sahin
Hayrettin
H
Department of Urology, School of Medicine, Dicle University, Turkey. hsahin@dicle.edu.tr
Akay
Ali Ferruh
AF
Yilmaz
Gülsen
G
Taçyildiz
Ibrahim Halil
IH
Bircan
Mehmet Kamuran
MK
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006417:Hematuria / Q000453:epidemiology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D009392:Nephrectomy; D011859:Radiography; D012189:Retrospective Studies; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000401:mortality; D014421:Turkey / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology* / Q000628:therapy