2023 Volume 59 Issue 1 Pages 37-43
Purpose: In renal trauma, there is no consensus on the nature of conservative treatment and the choices and methods of surgical intervention. We retrospectively investigated cases of renal trauma in our department.
Methods: Based on the medical records for renal trauma cases treated at our department between January 1990 and December 2018, a retrospective study was conducted on age, gender, cause/classification of renal trauma, other organ damage, abdominal trauma score, time to gross hematuria disappearance, treatment method, and in conservative management, duration of fasting/rest/antibiotics administration, complications, renal prognosis, and follow-up period. The renal trauma classification by the Japanese Association for the Surgery of Trauma (JAST Classification) was used.
Results: A total of 14 renal trauma cases, consisting of 3 class I, 4 class II cases, 6 class III, and one unknown, as graded on the JAST Classification, were included. Conservative management was implemented for 12 cases and surgical intervention in 2 cases who presented hemodynamic instability and got uncontrollable infection. Apart from the nephrectomy, renovascular damage, and lost to follow-up cases after the conservative management, renal function in 8 cases could be preserved. The median fasting period after admission was 2 (0 to 10) days, bed rest was 5.5 (1 to 25) days, and intravenous antibiotic administration was 10.5 (0 to 26) days.
Conclusion: This study found that making conservative management as the first choice of treatment was an effective strategy. Furthermore, suggesting the importance of constantly investigating the need for surgical intervention.
