Management of children with kidney injuries of various severity: a series of clinical observations
- Authors: Kovarsky S.L.1,2, Zakharov A.I.2, Sottaeva Z.Z.1,2, Struyansky K.A.2, Shvedova L.M.1, Shvedov V.A.1
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Affiliations:
- Russian National Research Medical University named after N.I. Pirogov
- N.F. Filatov Children's City Hospital
- Issue: Vol 28, No 5 (2024)
- Pages: 518-528
- Section: CASE REPORTS
- Submitted: 10.03.2023
- Accepted: 12.06.2024
- Published: 11.11.2024
- URL: https://jps-nmp.ru/jour/article/view/632
- DOI: https://doi.org/10.17816/ps632
- ID: 632
Cite item
Abstract
BACKGROUND: Kidney injury takes approximately 1–5% of all urinary tract and abdominal cavity injuries. Children blunt trauma amounts more than 90% of all kidney damages. Kidney injury is always followed by pain in the lumbar region and abdomen as well as by hematoma and hematuria. Serious renal injuries in children are more often accompanied by stable vital functions and normal general urine analyses compared to adults. Such patients require dynamic observation and instrumental examination so as to determine further curative strategy.
CLINICAL CASE DESCRIPTION: This article describes three clinical cases of kidney injury in children. In the first case, ultrasound examination and computed tomography revealed contusion changes in the kidney, subcapsular hematoma and renal parenchyma rupture without damage of the collecting system. Due to clinical findings, ultrasound and computed tomography examination, conservative management was prescribed to one patient, while for the other two with renal parenchyma rupture — surgery. One of these patients had malformation — a gap between the upper and lower segments of the double kidney. Such malformation could aggravate the injury.
CONCLUSION: The present series of clinical observations is an example of managing children with kidney injuries of varying severity. Depending on the damage severity, conservative management or surgical tactics are chosen by specialists.
Keywords
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About the authors
Semyon L. Kovarsky
Russian National Research Medical University named after N.I. Pirogov; N.F. Filatov Children's City Hospital
Email: semen2150@mail.ru
ORCID iD: 0000-0001-6310-7110
SPIN-code: 9308-5014
MD, Dr. Sci. (Medicine), Professor
Россия, Moscow; MoscowAndrey I. Zakharov
N.F. Filatov Children's City Hospital
Email: zaharov@pedurology.ru
ORCID iD: 0000-0002-8415-4968
SPIN-code: 8774-5827
MD, Cand. Sci. (Medicine)
Россия, MoscowZuleikha Z. Sottaeva
Russian National Research Medical University named after N.I. Pirogov; N.F. Filatov Children's City Hospital
Email: sottaeva@pedurology.ru
ORCID iD: 0000-0003-2522-904X
SPIN-code: 5275-0034
MD, Cand. Sci. (Medicine)
Россия, Moscow; MoscowKirill A. Struyansky
N.F. Filatov Children's City Hospital
Email: kirill-str89@mail.ru
ORCID iD: 0000-0002-1947-1035
MD, Cand. Sci. (Medicine)
Россия, MoscowLeyla M. Shvedova
Russian National Research Medical University named after N.I. Pirogov
Author for correspondence.
Email: leyla2903@yandex.ru
ORCID iD: 0000-0001-9626-7663
Россия, Moscow
Vladimir A. Shvedov
Russian National Research Medical University named after N.I. Pirogov
Email: shvedovvvladimir@yandex.ru
ORCID iD: 0000-0001-8207-7922
Россия, Moscow
References
- Razumovsky AY. Detskaya hirurgiya. Nacionalnoe rukovodstvo. 2nd. Moscow; 2021. 1280 p. (In Russ.)
- Razin MP, Galkin VN, Sukhoi NK. Detskaya urologiya-andrologiya: Textbook. Moscow: GEOTAR-Media; 2011. 128 p. (In Russ.)
- Lynch TH, Martínez-Piñeiro L, Plas E, et al. European Association of Urology. EAU guidelines on urological trauma. Eur Urol. 2005;47(1):1–15. doi: 10.1016/j.eururo.2004.07.028
- Kozar RA, Crandall M, Shanmuganathan K, et al. AAST Patient Assessment Committee. Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg. 2018;85(6):1119–1122. doi: 10.1097/TA.0000000000002058
- Abdullazhanov MM, Maksumov KJ. Kidney injury: Modern methods of diagnosis and treatment. Vestnik ekstrennoi meditsiny. 2009;(3):73–77. (In Russ.)
- Al-Shukri SH, Borovets SY, Dubinsky VY. Clinical recommendation for first medical emergency treatment for patients with kidney and ureter trauma. Urologicheskie vedomosti. 2014;4(1):20–23. EDN: SXLNYZ
- Sabounji SM, Gueye D, Ngom G. Blunt abdominal trauma in children: A review of 105 cases. J Indian Assoc Pediatr Surg. 2023;28(1):48–53. doi: 10.4103/jiaps.jiaps_171_21
- Çoşkun N, Abasiyanik A. Discussion of follow-up and treatment results of children with high-grade renal trauma. Cureus. 2024;16(1):e51618. doi: 10.7759/cureus.51618
- Coccolini F, Moore EE, Kluger Y, et al. WSES-AAST Expert Panel. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 2019;(14):54. EDN: JDJPOP doi: 10.1186/s13017-019-0274-x
- Duarsa GW, Satyagraha P. Non-operative management for high-grade isolated renal trauma in pediatric patients: A case series. Pan African Med J. 2023;(44):71. EDN: PGOAMB doi: 10.11604/pamj.2023.44.71.36833