OUTCOME OF RENAL TRAUMA IN A TERTIARY CARE CENTER OF NEPAL: A RETROSPECTIVE STUDY

Abstract

Background: Management of renal trauma has evolved over past decades from surgical exploration to renal preservation. Conservative management of high-grade renal trauma is possible due to advancement in imaging modality, dedicated critical care and availability of selective embolization. The objective to this research was to analyze the demographics, characteristics and management of renal trauma in our institution.

Methods: All patient who were admitted to College of Medical Sciences Teaching Hospital with diagnosis of renal trauma from 2017 to 2022 were retrospectively analyzed. Ethical approval was taken from institutional review committee of college of Medical Sciences. Data was collected from hospital medical records. Data was analyzed using descriptive statistical tools. For the categorical variable frequency and percentage was calculated while for continuous variables mean and standard deviation was calculated.

Results: Sixty-three patients were included in this study and Median age of patient admitted with renal trauma was 31 years with male to female ratio of 7:3. Blunt renal trauma was the most common type (96.8 %) with Road traffic accidents responsible for the majority of mechanisms of injury 66.7% (42) followed by fall 11(17.5%). Majority of Renal trauma was in AAST Grade III 26(41.3%). Right sided renal injury was common 33 (52.4%) than left sided renal injury 30 (47.6%). Intervention was required in 9 patients.

Conclusions: High-grade renal trauma can be managed conservatively in selected cases with close monitoring in critical care unit and with use of minimally invasive technique such as Selective angioembolization, Double J Ureteric stenting or Nephrostomy Insertion. But hemodynamically unstable patient after resuscitation warrants immediate surgical exploration.