Harper Katrina, Shah Kaushal H
Department of Emergency Medicine, Ichan School of Medicine at Mount Sinai, New York, New York 10029, USA.
J Emerg Med. 2013 Sep;45(3):400-4. doi: 10.1016/j.jemermed.2013.03.043. Epub 2013 Jul 8.
The kidney is the third most common solid organ injury in blunt abdominal trauma. The preferred treatment of blunt kidney injury varies according to grade of severity, with a preference for non-operative management in most instances.
We examine an unusual case of blunt renal trauma. In this case, our patient presented with severe flank pain and hematuria after a game of softball. Our focused abdominal sonography for trauma revealed fluid in the splenorenal recess concerning for intra-abdominal injury, and subsequent abdominal computed tomography confirmed a grade IV kidney laceration.
Our patient was managed medically despite his high grade of injury. This article reviews the diagnosis and management of blunt renal trauma and highlights the fact that despite significant injury, a patient can go on to do well with conservative management alone.
肾脏是钝性腹部创伤中第三常见的实体器官损伤。钝性肾损伤的首选治疗方法因严重程度而异,在大多数情况下倾向于非手术治疗。
我们检查了一例不寻常的钝性肾损伤病例。在该病例中,我们的患者在一场垒球比赛后出现严重的侧腹疼痛和血尿。我们的创伤重点腹部超声检查发现脾肾隐窝有液体,提示腹腔内损伤,随后的腹部计算机断层扫描证实为IV级肾裂伤。
尽管我们的患者损伤程度较高,但仍采用了保守治疗。本文回顾了钝性肾损伤的诊断和治疗,并强调了这样一个事实,即尽管损伤严重,但患者仅通过保守治疗仍可恢复良好。