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印度尼西亚三级转诊医院中儿童重度肾创伤的管理:病例系列及文献综述

Management of high-grade pediatric renal trauma in tertiary referral hospital in Indonesia: A case series and literature review.

作者信息

Wirjopranoto Soetojo, Azmi Yufi Aulia, Soetanto Kevin Muliawan

机构信息

Department of Urology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Department of Urology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

出版信息

Int J Surg Case Rep. 2024 May;118:109671. doi: 10.1016/j.ijscr.2024.109671. Epub 2024 Apr 21.

Abstract

INTRODUCTION AND IMPORTANCE

Genitourinary tract injuries constitute 10 % of all traumas, with renal injuries being common in pediatric cases due to reduced perirenal fat and abdominal wall muscle development. However, very few reports of pediatric renal trauma in Indonesia have been reported. In this case series, We present a case series of high-grade renal injury and review the literature on pediatric renal trauma in Indonesia.

CASE PRESENTATION

We present four cases with renal trauma as the subjects of this case study. The 13-year-old boy, who was the initial patient, complained of hematuria and abdominal pain after falling from a tree. The second patient, the 13-year-old boy, presented with left lower back pain and hematuria after being elbowed in the left waist. The third patient, a 14-year-old boy, had been in a motorcycle accident and got grade 5 renal injury according to AAST classification. The final case involved a 4-year-old boy who experienced recurrent hematuria caused by a pseudoaneurysm following blunt renal trauma.

DISCUSSION

Trauma is the leading cause of morbidity and mortality in children, with approximately 3 % of children assessed in pediatric hospital trauma departments having had trauma. With appropriate management according to guidelines, mortality can be avoided.

CONCLUSION

The case series highlights the significance of treating pediatric renal trauma patients individually according to their hemodynamic state and degree of impairment.

摘要

引言与重要性

泌尿生殖道损伤占所有创伤的10%,由于肾周脂肪减少和腹壁肌肉发育不全,肾损伤在儿科病例中很常见。然而,印度尼西亚关于小儿肾创伤的报道极少。在本病例系列中,我们展示了一组重度肾损伤病例,并回顾了印度尼西亚小儿肾创伤的相关文献。

病例介绍

我们呈现了4例肾创伤病例作为本病例研究的对象。首例患者是一名13岁男孩,从树上跌落之后出现血尿和腹痛。第二例患者也是一名13岁男孩,左腰部被肘部撞击后出现左下腹疼痛和血尿。第三例患者是一名14岁男孩,遭遇摩托车事故,根据美国创伤外科学会(AAST)分类为5级肾损伤。最后一例是一名4岁男孩,钝性肾创伤后因假性动脉瘤出现反复血尿。

讨论

创伤是儿童发病和死亡的主要原因,在儿科医院创伤科接受评估的儿童中,约3%曾遭受创伤。按照指南进行适当处理可避免死亡。

结论

该病例系列强调了根据小儿肾创伤患者的血流动力学状态和损伤程度进行个体化治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e374/11063531/1fc2a675dcde/gr1.jpg

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