Publication:

A prospective observational study on the optimal management approach based on the clinical profile of renal trauma patients

Introduction The kidney is the most commonly injured genitourinary organ following trauma. It can be a result of both blunt and penetrating trauma to the abdomen. Both conservative and surgical managements are employed as per the clinical profile of the patient.

Methods This prospective observational study included all the patients with renal trauma who presented at the ER. Computed tomography (CT) was done for grading of renal trauma.

Results A total of 60 patients were included in the study. Eighty percent (n=48) patients were managed conservatively. Twenty percent (n=12) patients underwent some form of surgical management. The mean (SD) hospital stay as 11.38 (6.94) days. Twenty-eight patients (46.67%) had right renal injury. Thirty-two patients (53.33%) had left renal involvement. There were no patients with bilateral renal injury. According to American association for the surgery of trauma (AAST), 11.66% patients (n=7) were categorised in grade I, 20% patients (n=12) to grade II, 33.33% patients (n=20) to grade III, 25% patients (n=15) to grade IV and 10% patients (n=6) to grade V. The most common associated injuries were rib fracture and visceral injury.

Conclusion Much has changed since historical times with regards to renal trauma management. Data from various studies point towards a paradigm shift from surgical to conservative management as the standard of care irrespective of the grade and mode of renal trauma.