Unusual Course of Renal Trauma in a Toddler in a Tertiary Care Hospital

Renal trauma can be from direct, blunt, penetrating and iatrogenic injury. Renal injuries are accounting for 10% of abdominal trauma. In our case the renal injury of the toddler is due to blunt injury. Depending upon the preexisting congenital or acquired renal pathology, its incidence increases. Blunt trauma comprises more than 95% of traumatic renal injury. Patients with renal trauma present with flank and/ or abdominal pain.

Children are at higher risk of renal injury from blunt trauma than adults but no pediatric renal trauma guidelines have been established. Computed Tomography (CT) is the investigation of choice in the evaluation of blunt renal injury as our case. Ultrasound (USG) is helpful in detecting hemoperitoneum in patients with suspected intraperitoneal injury but less value in evaluating those with suspected extraperitonealinjury. FAST (Fast Abdominal Sonography for Trauma), thus is important. Renal angiogram, in some cases MRI or renal scintigraphy may be useful.

In our case, a toddler with blunt injury abdomen checked from April 2022 to April 2023 where a grade IV injury of right kidney with huge collection reduced to grade II-III hydronephrosis. The case was conservatively managed.