Ureteral trauma: patterns and mechanisms of injury of an uncommon condition.
BACKGROUND
Traumatic ureteral injuries are uncommon, thus large series are lacking.


METHODS
We performed a retrospective analysis of the National Trauma Data Bank (2002-2006).


RESULTS
Of the 22,706 genitourinary injuries, 582 ureteral injury patients were identified (38.5% blunt, 61.5% penetrating). Patients were 84% male, 38% white, and 37% black (mean age, 31 y). Blunt trauma patients had a median Injury Severity Score of 21.5 versus 16.0 for penetrating injury (P < .001). Mortality rates were 9% blunt, and 6% penetrating (P = .166). Penetrating trauma patients had a higher incidence of bowel injuries (small bowel, 46%; large bowel, 44%) and vascular injuries (38%), whereas blunt trauma patients had a higher incidence of bony pelvic injuries (20%) (P < .001).


CONCLUSIONS
Ureteral injuries are uncommon, seen in approximately 3 per 10,000 trauma admissions, and occur more in penetrating than in blunt trauma. The most common associated injury for blunt ureteral trauma is pelvic bone fracture, whereas penetrating ureteral trauma patients have more hollow viscus and vascular injuries.
Siram
Suryanarayana M
SM
Department of Surgery, Howard University College of Medicine, 2041 Georgia Avenue, NW, Washington, DC 20060, USA. ssiram@howard.edu
Gerald
Sonja Z
SZ
Greene
Wendy R
WR
Hughes
Kakra
K
Oyetunji
Tolulope A
TA
Chrouser
Kristin
K
Cornwell
Edward E
EE
Chang
David C
DC
D000328:Adult; D016208:Databases, Factual; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D007083:Iliac Artery / Q000293:injuries; D015601:Injury Severity Score; D008297:Male; D010388:Pelvis / Q000293:injuries; D012077:Renal Artery / Q000293:injuries; D012082:Renal Veins / Q000293:injuries; D013124:Spinal Injuries / Q000150:complications; D014481:United States / Q000453:epidemiology; D014513:Ureter / Q000293:injuries* / Q000503:physiopathology; D014515:Ureteral Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D014682:Vena Cava, Inferior / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000503:physiopathology; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000503:physiopathology