Management of Blunt Renal Trauma in Srinagarind Hospital: 10-Year Experience
Chaiyut Thanapaisal MD*, Wichien Sirithanaphol MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Renal trauma is the most common injury in the urogenital system. In the last decade the management has been
shifted from a mandatory exploration to conservative treatment. So, the present study was conducted to evaluate the result of
renal trauma patients.
Material and Method: The data of renal trauma patients treated at Srinagarind Hospital since 1 January 1998 to 31
December 2007 was collected. Clinical data and trauma score were obtained via medical record review.
Results : Sixty-nine patients were included; 59 were male (82%). Mean age was 29.8 years (1-68 years). Forty-nine patients
(80%) were injured by traffic accident. Eighteen percents of patients also had splenic injury. Fifty-five patients (80%) of blunt
renal injury patients were treated by Non-Operative Management (NOM). In this group, most patients had grade I injury
(39%). Mean injury severity score (ISS), revised trauma score (RTS), trauma and injury severity score (TRISS) were 20, 7.3,
and 0.93, respectively. Successful rate of non-operative management was 87.2%. Mean hospital stay was 11.8 days and
urinary tract infection was the most frequent complication (10%).
Fourteen patients (20%) underwent surgery. Mean ISS, RTS, TRISS were 20.8, 5.5, and 0.72, respectively. In the
operative group, 71% were grade 5 injury and almost all were treated by nephrectomy. Mean hospital stay was 19 days.
Conclusion : Blunt injury is the major cause of renal trauma and the main mechanism is traffic accident. The success rate of
Non-Operative Management in Srinagarind Hospital was high. However, operative management is still the standard
treatment in unstable patients.
Keywords : Renal trauma, KUB trauma, Abdominal trauma
