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Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series

The kidney is the most commonly injured urinary tract organ in pediatric trauma with blunt mechanisms, causing around 80% of cases. Non-operative management (NOM) remained the first choice for minor blunt renal trauma; however, its value for major trauma is still under debate. We present three child...

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Autores principales: Duarsa, Gede Wirya Diptanala Putra, Satyagraha, Paksi, Daryanto, Besut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162895/
https://www.ncbi.nlm.nih.gov/pubmed/37159632
http://dx.doi.org/10.11604/pamj.2023.44.71.36833
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author Duarsa, Gede Wirya Diptanala Putra
Satyagraha, Paksi
Daryanto, Besut
author_facet Duarsa, Gede Wirya Diptanala Putra
Satyagraha, Paksi
Daryanto, Besut
author_sort Duarsa, Gede Wirya Diptanala Putra
collection PubMed
description The kidney is the most commonly injured urinary tract organ in pediatric trauma with blunt mechanisms, causing around 80% of cases. Non-operative management (NOM) remained the first choice for minor blunt renal trauma; however, its value for major trauma is still under debate. We present three children with high-grade isolated renal trauma diagnosed using computed tomography scans and treated using NOM as the main strategy of treatment. The first patient (12-year-old) fully recovered without needing an auxiliary procedure. The second patient (6-year-old) developed urinoma and underwent percutaneous drainage of urinoma and double J stent (DJ) with an uneventful result. The third patient (14-year-old) developed urinoma and underwent percutaneous drainage and DJ stent. However, he experienced continuous hematuria that was treated via super-selective embolization. In conclusion, NOM for isolated high-grade renal trauma is feasible with good outcomes. If complications were developed during follow-up, minimally invasive procedures, such as super-selective angioembolization in continuing hemorrhage and initial drainage in urinoma, offered a comparable outcome without needing open surgery.
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spelling pubmed-101628952023-05-07 Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series Duarsa, Gede Wirya Diptanala Putra Satyagraha, Paksi Daryanto, Besut Pan Afr Med J Case Series The kidney is the most commonly injured urinary tract organ in pediatric trauma with blunt mechanisms, causing around 80% of cases. Non-operative management (NOM) remained the first choice for minor blunt renal trauma; however, its value for major trauma is still under debate. We present three children with high-grade isolated renal trauma diagnosed using computed tomography scans and treated using NOM as the main strategy of treatment. The first patient (12-year-old) fully recovered without needing an auxiliary procedure. The second patient (6-year-old) developed urinoma and underwent percutaneous drainage of urinoma and double J stent (DJ) with an uneventful result. The third patient (14-year-old) developed urinoma and underwent percutaneous drainage and DJ stent. However, he experienced continuous hematuria that was treated via super-selective embolization. In conclusion, NOM for isolated high-grade renal trauma is feasible with good outcomes. If complications were developed during follow-up, minimally invasive procedures, such as super-selective angioembolization in continuing hemorrhage and initial drainage in urinoma, offered a comparable outcome without needing open surgery. The African Field Epidemiology Network 2023-02-06 /pmc/articles/PMC10162895/ /pubmed/37159632 http://dx.doi.org/10.11604/pamj.2023.44.71.36833 Text en Copyright: Gede Wirya Diptanala Putra Duarsa et al. https://creativecommons.org/licenses/by/4.0/The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Series
Duarsa, Gede Wirya Diptanala Putra
Satyagraha, Paksi
Daryanto, Besut
Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series
title Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series
title_full Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series
title_fullStr Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series
title_full_unstemmed Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series
title_short Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series
title_sort non-operative management for high-grade isolated renal trauma in pediatric patients: a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162895/
https://www.ncbi.nlm.nih.gov/pubmed/37159632
http://dx.doi.org/10.11604/pamj.2023.44.71.36833
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