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Renal trauma in children

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https://www.readbyqxmd.com/read/28403495/-diagnosis-and-therapeutic-management-in-kidney-ureter-and-bladder-trauma
#1
Karin Hirsch, Marco Heinz, Bernd Wullich
Trauma refers to the destruction of tissues or organs by external forces and it is the most common cause of mortality and morbidity in children (1, 2). Injuries of the genitourinary tract may be the result of blunt (falls, sport injuries, motor vehicle accidents and sexual abuse) or penetrating (stab wounds, gun shots, falling onto sharp objects) injuries. The genitourinary tract is significantly injured in 2.9% of paediatric trauma patients 4.In the paediatric population, the kidney is the most affected organ in the genitourinary tract (>60% of all genitourinary tract injuries) 4...
February 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28042220/internal-carotid-artery-fibromuscular-dysplasia-in-a-child-incidental-postmortem-finding-after-head-injury
#2
Arulselvi Subramanian, Garima Aggarwal, Deepak Agarwal, Sanjeev Lalwani
Fibromuscular dysplasia (FMD) is a rare, segmental, nonatheromatous, and noninflammatory arterial disease of unknown etiology. It predominantly involves renal artery (60-75%) followed by extracranial part of the internal carotid artery and vertebral arteries (25-30%). The disease typically affects middle-aged women and involves intermediate-sized arteries throughout the body. There are rare case reports of extracranial FMD compounding a trauma case. A patient was brought to trauma center emergency with a history of fall from height...
January 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/27992751/blunt-abdominal-trauma-from-motor-vehicle-collisions-from-2007-to-2011-renal-injury-probability-and-severity-in-children-versus-adults
#3
Michael P Kurtz, Jairam R Eswara, Joel M Vetter, Caleb P Nelson, Steven B Brandes
PURPOSE: There are sparse data directly comparing the probability of renal injury in children and adults. The kidney of the child is believed to be more susceptible to blunt injury for a variety of anatomical reasons. In a large cohort we tested the hypothesis that the pediatric kidney is more susceptible to any renal injury and to higher grade injury. MATERIALS AND METHODS: We queried the NTDB® (National Trauma Data Bank®) on all hospital admissions following motor vehicle collisions in a pediatric population (age less than 21 years) and a referent adult population (age 30 to 50 years)...
March 2017: Journal of Urology
https://www.readbyqxmd.com/read/27959665/retrospective-analysis-of-the-safety-and-cost-implications-of-pediatric-contrast-enhanced-ultrasound-at-a-single-center
#4
Gibran T Yusuf, Maria E Sellars, Annamaria Deganello, David O Cosgrove, Paul S Sidhu
OBJECTIVE: Because of concern over medical ionizing radiation exposure of children, contrast-enhanced ultrasound (CEUS) has generated interest as an inexpensive, ionizing radiation-free alternative to CT and MRI. CEUS has received approval for pediatric hepatic use but remains off-label for a range of other applications. The purposes of this study were to retrospectively analyze adverse incidents encountered in pediatric CEUS and to assess the financial benefits of reducing the number of CT and MRI examinations performed...
February 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27890687/revisiting-sports-precautions-in-children-with-solitary-kidneys-and-congenital-anomalies-of-the-kidney-and-urinary-tract
#5
REVIEW
Dimitri Papagiannopoulos, Edward Gong
This review article explores sports and recreational precautions in children with solitary kidneys. In 2001, the American Academy of Pediatrics published recommendations for activity in children with medical conditions. Those with solitary kidneys were graded a "qualified yes": no restriction in noncontact sports, and individual assessment for limited-contact, contact, and collision sports. Recent trauma data suggest that classification according to the degree of contact is inaccurate. We propose an updated, data-driven classification of sports or recreation according to the risk of high-grade renal trauma or loss of renal unit...
November 24, 2016: Urology
https://www.readbyqxmd.com/read/27813386/retroperitoneoscopic-pyelolithotomy-a-good-alternative-treatment-for-renal-pelvic-calculi-in-children
#6
Bruno Nicolino Cezarino, Rubens Park, Paulo Renato Marcelo Moscardi, Roberto Iglesias Lopes, Francisco T Denes, Miguel Srougi
INTRODUCTION: Nephrolitiasis, once considered an adult disease, has become increasingly prevalent in children, with na increase from 6% to 10 % annually in past 25 years. Kidney stones in pediatric population can result from metabolic diseases in up to 50% of children affected. Other factors associated with litiasis are infection, dietary factors, and anatomic malformations of urinary tract. Standard treatment procedures for pediatric population are similar to adult population. Extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS), percutaneous nepfrolithotomy (PCNL), as well as laparoscopic and retroperitoneoscopic approaches can be indicated in selected cases...
November 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27806534/association-between-adrenal-hematoma-and-mortality-in-pediatric-multiple-blunt-traumas-an-autopsy-evaluation
#7
Farrokh Taftachi, Leyla Abdolkarimi, Maryam Ameri, Azadeh Memarian, Alireza Behzadi, Hooman Bakhshandeh
Adrenal hematoma is a common hidden catastrophic complication in pediatric victims of multiple blunt traumas. Adrenal hematoma has no obvious symptoms and may not be detected by diagnostic methods such as magnetic resonance imaging, computed tomography scan, and sonography; consequently, this complication may be neglected in children with multiple blunt traumas and cause death through sudden adrenal crisis.The current study was conducted on 55 dead children (<13 y) and 110 matured youths (13-17 y) who died in consequence of multiple blunt traumas, comprising car crashes, fall from heights, and falling debris...
August 4, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27614121/management-of-renal-artery-occlusion-related-to-multiple-trauma-in-children-two-case-reports
#8
Guofeng Xu, Lei He, Xiaoliang Fang, Dapeng Jiang, Longhu Jin, Houwei Lin, Maosheng Xu, Yeming Wu, Hongquan Geng
We report 2 successful treatment cases of renal artery occlusion (RAO) related to multiple trauma. A 4-year-old boy was diagnosed with right RAO and liver laceration after a traffic accident. Surgical thrombectomy and revascularization were performed, but the lacerated liver was not sutured. The lacerated liver was surgically repaired 6 days post operation because of delayed bleeding. Thirteen percent of the patient's right kidney function was conserved. Another 7-year-old boy was compressed by an agitator...
September 8, 2016: Urology
https://www.readbyqxmd.com/read/27552936/-management-of-blunt-renal-trauma-in-paediatric-patients
#9
L Brouwers, M Bemelman, W L M Kramer, F H W M van der Heijden
- In 90% of children, blunt abdominal trauma is the cause of renal, splenic or hepatic injury or an injury affecting a combination of these organs.- Because children's kidneys are anatomically less protected than those of adults, potential renal injury following direct trauma affecting the child's flank, for example by a handlebar or knee should be considered.- Symptoms of renal trauma include excoriations or haematoma on the flank, a 'seatbelt-sign', macroscopic haematuria and fractures of the ribs and vertebra...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27529029/overview-of-point-of-care-abdominal-ultrasound-in-emergency-and-critical-care
#10
REVIEW
Toru Kameda, Nobuyuki Taniguchi
Point-of-care abdominal ultrasound (US), which is performed by clinicians at bedside, is increasingly being used to evaluate clinical manifestations, to facilitate accurate diagnoses, and to assist procedures in emergency and critical care. Methods for the assessment of acute abdominal pain with point-of-care US must be developed according to accumulated evidence in each abdominal region. To detect hemoperitoneum, the methodology of a focused assessment with sonography for a trauma examination may also be an option in non-trauma patients...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27444361/surgical-treatment-of-abdominal-aortic-aneurysms-in-infancy-and-early-childhood
#11
Jonathan L Eliason, Dawn M Coleman, Enrique Criado, James C Stanley
OBJECTIVE: Pediatric abdominal aortic aneurysms (AAAs) are rare. The intent of this report was to review the presentation and surgical management of AAAs in infancy and early childhood. METHODS: The clinical courses of young children undergoing AAA surgery were subjected to a retrospective review and analysis. RESULTS: Eleven children, nine boys and two girls, ranging in age from 2 weeks to 6 years, underwent surgical treatment of AAA at the University of Michigan from 2002 to 2014...
November 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27258506/posterior-reversible-encephalopathy-syndrome-complicating-traumatic-pancreatitis-a-pediatric-case-report
#12
Anna Sigurtà, Valeria Terzi, Caroline Regna-Gladin, Roberto Fumagalli
We are reporting a case of posterior reversible encephalopathy syndrome (PRES) developed in an unusual clinical scenario without the presence of the most described symptoms. PRES is a neurological and radiological syndrome described in many different clinical conditions. In children it has been mostly reported in association with hematological and renal disorders.Our patient was a 15 years old boy, admitted to our intensive care unit for pancreatitis after blunt abdominal trauma.During the stay in the intensive care unit, he underwent multiple abdominal surgical interventions for pancreatitis complications...
May 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27160977/imaging-characteristics-associated-with-failure-of-nonoperative-management-in-high-grade-pediatric-blunt-renal-trauma
#13
J K Au, X Tan, M Sidani, I Stanasel, D R Roth, C J Koh, A Seth, P C Gargollo, D Tu, E T Gonzales, T G Smith, N Janzen
INTRODUCTION: Some children who sustain high-grade blunt renal injury may require operative intervention. In the present study, it was hypothesized that there are computed tomography (CT) characteristics that can identify which of these children are most likely to need operative intervention. MATERIALS AND METHODS: A retrospective review was performed of all pediatric blunt renal trauma patients at a single level-I trauma center from 1990 to 2015. Inclusion criteria were: children with American Association for the Surgery of Trauma (AAST) Grade-IV or V renal injuries, aged ≤18 years, and having available CT images with delayed cuts...
October 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27120318/the-use-of-angiography-in-pediatric-blunt-abdominal-trauma-patients
#14
Stephen J Fenton, Kristin N Sandoval, Austin M Stevens, Eric R Scaife
BACKGROUND: Angiography is a common treatment used in adults with blunt abdominal trauma and/or severe pelvic fractures. The Committee on Trauma of the American College of Surgeons has recently advocated for this resource to be urgently available at pediatric trauma centers; however, its usefulness in the pediatric setting is unclear. The purpose of this study was to determine the incidence of angiography in the treatment of blunt abdominal trauma among injured children. METHODS: An analysis was performed using an established public use data set of children (younger than 18 years) treated at 20 participating trauma centers for blunt torso trauma through the Pediatric Emergency Care Applied Research Network...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27075018/diagnostic-imaging-of-blunt-abdominal-trauma-in-pediatric-patients
#15
REVIEW
Vittorio Miele, Claudia Lucia Piccolo, Margherita Trinci, Michele Galluzzo, Stefania Ianniello, Luca Brunese
Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements...
May 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/26850907/pediatric-abdominal-injury-patterns-caused-by-falls-a-comparison-between-nonaccidental-and-accidental-trauma
#16
Kyle W Carter, Steven L Moulton
BACKGROUND/PURPOSE: Falling from a low height is the most common history given by caregivers of pediatric nonaccidental trauma (NAT) victims evaluated for blunt abdominal trauma (BAT). The purpose of this study is to compare the patterns of injuries seen in children with BAT who are victims of NAT with those seen after a fall-related incident. METHODS: Trauma database query from regional pediatric trauma centers identified patients were who were evaluated for BAT resulting from either NAT or a fall...
February 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26833463/management-of-high-grade-renal-injury-in-children
#17
M H Okur, S Arslan, B Aydogdu, M S Arslan, C Goya, H Zeytun, E Basuguy, I Uygun, M K Çigdem, A Önen, S Otcu
INTRODUCTION: The management of severe renal trauma is disputable. Herein, we present diagnosis and treatment of patients with high-grade renal injury (grades IV and V). MATERIALS AND METHODS: The records of 31 patients with severe renal trauma who were treated between 2009 and 2014 were analyzed retrospectively. All patients' CT results were evaluated by two radiologists and assigned grades of IV or V in accordance with the American Association for the Surgery of Trauma Organ Injury Severity Scale...
February 1, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/26815621/examining-the-impact-of-renal-trauma-guidelines-on-urologists-in-uk
#18
Davendra Sharma, Nadeem Butt, Barnaby Barrass, Christopher Dawson
OBJECTIVE: To investigate whether urologists in UK utilise and adhere to recently published renal trauma guidelines. METHODS: A one-page anonymous questionnaire was created based on recently published guidelines. Thirteen questions were used to investigate the current patterns of practice. The questionnaire was posted to 500 consultants in UK. RESULTS: Out of 500 questionnaires, 152 (30%) were returned; 109 (70%) respondents saw an estimated five or less cases of renal trauma per year; 104 (71%) respondents used guidelines but these differed; 79 (52%) respondents believed that the published guidelines were appropriate for UK practice; 8 (5%) did not feel that they were appropriate and 48 (32%) were unsure, and 30 (20%) used local guidelines...
April 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/26804218/pediatric-nonaortic-arterial-aneurysms
#19
Frank M Davis, Jonathan L Eliason, Santhi K Ganesh, Neal B Blatt, James C Stanley, Dawn M Coleman
OBJECTIVE: Pediatric arterial aneurysms are extremely uncommon. Indications for intervention remain poorly defined and treatments vary. The impetus for this study was to better define the contemporary surgical management of pediatric nonaortic arterial aneurysms. METHODS: A retrospective analysis was conducted of 41 children with 61 aneurysms who underwent surgical treatment from 1983 to 2015 at the University of Michigan. Arteries affected included: renal (n = 26), femoral (n = 7), iliac (n = 7), superior mesenteric (n = 4), brachial (n = 3), carotid (n = 3), popliteal (n = 3), axillary (n = 2), celiac (n = 2), ulnar (n = 2), common hepatic (n = 1), and temporal (n = 1)...
February 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26713980/management-of-pediatric-blunt-renal-trauma-a-systematic-review
#20
REVIEW
Elyse LeeVan, Osnat Zmora, Francesca Cazzulino, Rita V Burke, Jessica Zagory, Jeffrey Scott Upperman
BACKGROUND: Blunt trauma remains a significant cause of morbidity and mortality in the pediatric population. The use of conservative management for blunt renal trauma is widely accepted in adult trauma literature and is now increasingly accepted for use in the pediatric patient population. This study aimed to review current practices in pediatric blunt renal trauma management and to highlight current practices in conservative protocols, success rates of conservative management strategies, as well as short- and long-term outcomes of blunt renal trauma management...
March 2016: Journal of Trauma and Acute Care Surgery
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