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Functional sequelae after renal trauma

Q. Ballouhey, F. Lemasson, L. Carfagna, A. Le Mandat, J. Guitard, J. Moscovici, P. Galinier

Children Hospital, CHU Toulouse, France

 

ABSTRACT

Introduction: The aim of this study is to evaluate the renal function by DMSA technetium-99m scintigraphy, some time after the traumatic event.

Material and methods: It is a retrospective study that reviews files of 54 children with renal traumas between 1990 and 2008. We have excluded 2 early deaths and 7 patients lost to follow-up. There were 45 patients (8,7 years, 2- 15 years old), all stages and types of treatment included, who underwent ultrasound and abdominal tomodensitometry, blood pressure measurement, serum creatinine dosage and 20 of them, after complete healing underwent a scintigraphy. We have classified them in accordance with the international classification of the American Association for the Surgery of Trauma.

Results: 13 of them had renal trauma stage I-II, 9 stage III , 20 stage IV and 3 stage V . There were no bilateral injuries. Ten patients underwent urgent laparotomy; 2 of them had haemostatic nephrectomies and the other 2 had partial nephrectomies. Three vascular injuries have been treated by angioplasty. Three urohematomas have been drained by 2 double J stents and one external drainage. At long term follow- up no child presented with arterial hypertension or elevated blood creatinine level. At scintigraphy, the total residual renal function was 42. 4% (±6, 3%), 40. 8 %( ±7%) and 40% (± 5%) [average ± (difference type)], respectively for the stages I-II (5 patients), III-IV (12 patients) and V (3 patients).

Conclusion: It seems that in all stages of renal trauma there are functional sequelae that need a close follow-up, in which the scintigraphic examination is essential.

 

Key words: renal trauma, functional prognostic, scintigraphy