Kidney injury in children

Kim, Han Gwun; Kim, Sun Jin; Kim, Kwang Myung; Choi, Hwang

Abstract

From October 1985 to March 1992 we experienced 18 cases of childhood kidney injury. All cases were blunt injury and could be classified as renal contusion (38.9%), minor renal laceration (16.7%). major renal laceration (33.3%) and renal pedicle injury (11.1%). Thirteen patients were treated conservatively and 3 patients were undergone partial nephrectomy and 2 patien1s were undergone nephrectomy. All five cases were classified as major laceration. One patient of major renal laceration was treated conservatively and recovered without delayed operation and functional impairment on follow-up 99Tc-DTPA. Two vascular injured children were treated conservatively owing to delayed identification. The most important clinical sign of severe injury was the rate of hemoglobin decrease (p<0.05). In case of normal IVP and microscopic hematuria, there was no need to further radiologic work-up and it may be treated conservatively without complication or delayed operation. The computerized tomography was the most accurate diagnostic tool in evaluating renal trauma especially in cases of multiple organ trauma. There was no hypertension secondary to renal trauma in 6 patients whose blood pressure was followed up for average 9 months.