Early Surgery in the Management of Pediatric Blunt Renal Trauma

Abstract

Of 40 children with major renal injuries managed surgically 30 (75%) could be followed up to 13 yr postoperatively (mean 4.5 yr). Measurements of renal size on sequential excretory urograms demonstrated normal growth of the traumatized kidney in all but 1 child. No hypertrophy of the contralateral kidney was noted in any child. Kidney length correlated with renal plasma flow calculated by sequential scintiscans (r = 0.77). Hypertension was noted in 3 patients. Split renal vein renin studies and angiography showed that hypertension was caused by renal artery stenosis in 1 patient. Although no firm conclusions could be drawn with regard to the optimal management of major blunt renal injuries, precise data was presented that are valuable in comparison to other series of patients managed conservatively or surgically.