ISSN 2398-2969      

Kidney: trauma

icanis
Contributor(s):

Elisa Mazzaferro

Synonym(s): Renal trauma


Introduction

  • Kidneys are relatively protected by surrounding sublumbar muscles and ribs.
  • Cause: most injuries from road traffic accidents (RTA)/hit by car (HBC).
    In all cases of traumatic injury warn owner of potential complications at time of injury.
  • Signs: degree of injury determines pathophysiology, signs and management.
  • Diagnosis: imaging techniques.
  • Treatment: severe trauma requires urgent fluid replacement and possible nephrectomy.
  • Prognosis: good in mild cases; guarded if trauma is severe.

Pathogenesis

Etiology


Road traffic accidents
  • Surrounding structures (sublumbar muscles and ribs) can cause damage.
  • Kidney 'whiplashed' about its hilar structures to collide with these structures.
Ballistic injury
  • Cause direct renal damage.
  • Compromise renal blood supply.
Penetrating injury
  • May cause direct renal damage.
  • Secondary infection can result in renal complications.

Pathophysiology

  • Subcapsular hematoma.
  • Parenchymal rupture.
  • Renal crushing.
  • Avulsion of vessels/ureter.
  • Variable hemorrhage and hypovolemia.
  • Urine leakage and retroperitonitis.

Timecourse

  • Severe injuries acute (within hours).
  • More chronic signs may develop over days-weeks.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Other sources of information

  • Recent references from PubMed and VetMedResource.
  • Streeter E M, Rozanski E A, de LaForcade-Buress A, Freeman L M, Rush J E (2010) Evaluation of vehicular trauma in dogs: 239 cases (January-December 2001). JAVMA 235 (4), 405-408 PubMed.
  • Boysen S R, Rozanski E A, Tidwell A S, Holm J L, Shaw S P, Rush J E (2004) Evaluation of a focused assessment with sonography for trauma protocol to detect free abdominal fluid in dogs involved in motor vehicle accidents. JAVMA 225 (8), 1198-1204 PubMed.
  • Vinayak A & Krahwinkel D J (2004) Managing blunt trauma-induced hemoperitoneum in dogs and cats. Comp Contin Educ Pract Vet 26 (4), 276 VetMedResource.

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