The clinical observation on diagnosis and treatment of renal injury

Song, Yun Seob; Lee, Young Tae

Abstract

The clinical observation on diagnosis and treatment was made in 84 patients of renal injury during the period from 1983 to 1989. The results were as follows. 1. The sex ratio of male to female was 3.4:1 and the most favorable age was from 20 to 39 years for 46.4%. 2. The main cause of injury was nonpenetrating injury of which traffic accidents was the most common cause. 3. The associated injuries were seen in 100% of penetrating injury and 55.1% of nonpenetrating injury. The most common associated injury was diaphragmatic injury in penetrating injury and head injury in nonpenetrating injury. 4. Flank pain and hematuria were found in 91.7% and 84.5% in the patients with renal injury, respectively.5. IVP. CT scan, ultrasonography and retrograde pyelography were taken in 63. 50.5 and 2 patients. respectively for the diagnosis of renal injury. The frequency of minor. major and pedicle renal injury were 63.1%. 33.3% and 3.6%, respectively. 6. In minor injury. conservative treatment and renorrhaphy were performed in 98.1% and 1.9% and complication occurred in 3.8%. In major injury. conservative treatment. nephrectomy. partial nephrectomy and renorrhaphy were performed in 46.4%, 32.1%. .14.2% and 7.1%. respectively and complication occurred in 21.4%. In pedicle injury. nephrectomy was performed in 100% and complication was happened in 33.3%. From the viewpoint of the cause of injury, conservative treatment was performed in 16.7% in penetrating injury and 82.1% in nonpenetrating injury. In conclusion. the accurate diagnosis and treatment plan of renal injury with computed tomography are important. When the selection between conservative treatment and operative treatment is difficult, aggressive operative treatment is effective for the preservation of the injured kidney and the prevention of complications.