Management of blunt renal trauma in Srinagarind Hospital: 10-year experience.

BACKGROUND

Renal trauma is the most common injury in the urogenital system. In the last decade the management has beer shifted f rom a mandatory exploration to conservative treatment. So, the present study was conducted to evaluate the result f, renal trauma patients.

MATERIAL AND METHOD

The data of renal trauma patients treated at Srinagarind Hospital since 1 January 1998 to 31 December 2007 was collected. Clinical data and trauma score were obtained via medical record review.

RESULTS

Sixty-nine patients were included; 59 were male (82%). Mean age was 29.8 years (1-68 years). Forty-nine patiens: (80%) were injured by traffic accident. Eighteen percents of patients also had splenic injury. Fifty-five patients (80%) of blunt renal injury patients were treated by Non-Operative Management (NOM). In this group, most patients had grade I injury (39%). Mean injury severity score (ISS), revised trauma score (RTS), trauma and injury severity score (TRISS) were 20, 7.3 and 0.93, respectively. Successful rate of non-operative management was 87.2%. Mean hospital stay was 11.8 days and urinary tract infection was the most frequent complication (10%). Fourteen patients (20%) underwent surgery. Mean ISS, RTS, TRISS were 20.8, 5.5, and 0.72, respectively. In the operative group, 71% were grade 5 injury and almost all were treated by nephrectomy. Mean hospital stay was 9 days.

CONCLUSION

Blunt injury is the major cause of renal trauma and the main mechanism is traffic accident. The success rate of Non-Operative Management in Srinagarind Hospital was high. However operative management is still the standard treatment in unstable patients.