Pattern and management of renal injuries at Pakistan Institute of Medical Sciences.
OBJECTIVE
To determine the types and grade of various renal injuries and methods adopted for their management at the Department of Urology, Pakistan Institute of Medical Sciences, Islamabad.


METHODS
An observational study.


METHODS
Department of Urology, Pakistan Institute of Medical Sciences, Islamabad, from January 2005 to December 2007.


METHODS
The study included 50 patients with both blunt and penetrating renal trauma of either gender and aged above 13 years. Injuries, grade management and outcome was recorded. The data was entered in structured proforma and analyzed for descriptive statistics using SPSS version 10.


RESULTS
Frequency was higher in males (82%). The mode of renal injury was blunt in 78% and penetrating in 22% cases. Blunt injuries were mostly due to road traffic accident (94.9%) and penetrating injuries due to firearm (63.6%). Hematuria was present in 86% and absent in 14% cases. Minor renal injury was seen in 74% and major injury in 26% cases. Seventy-two percent of cases were managed conservatively. All grade-V (14%) and one grade-1V injury (2%) patients underwent nephrectomy. Renorrhaphy was done in 6% cases. Urinary extravasation was seen in one case (2%). One patient developed renocolic fistula. No mortality was observed in non-operative group; however, 4% patients expired in operative group due to associated injuries.


CONCLUSIONS
Blunt trauma accounts for majority of the cases of renal injury and non-operative treatment is the suitable method of management for most cases of blunt as well as selected cases of penetrating renal trauma, who are stable hemodynamically and without peritonitis.
Khan
Abdul Rahim
AR
Department of Urology, Pakistan Institute of Medical Sciences, Islamabad. arkhan71@hotmail.com
Fatima
Naheed
N
Anwar
Khursheed
K
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology; D010154:Pakistan; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D014950:Wounds, Penetrating / Q000601:surgery / Q000628:therapy*; D055815:Young Adult