Renal Trauma in an Adolescent of a Tertiary Care Hospital; Is Ultrasound Adequate?

Children are at high risk of renal injury from blunt trauma than adults. Renal trauma can be from direct, blunt, penetrating and iotrogenic injury. Renal injuries are accounting for 10% of abdominal trauma. In our cases, renal injury caused to patient after falling from bicycle in September 2023.

Depending upon the pre-existing congenital or acquired renal pathology, its incidence increases. Blunt trauma comprises more than 95% of traumatic renal injury. Patient with renal trauma present with flank &/or abdominal pain and with hematuria.

Computed tomography (CT) is the investigation of choice in evaluation of blunt renal injury. Ultrasound is helpful in detecting hemoperitonum in patients with suspected intraperitoneal injury. FAST (Fast Abdominal Sonography for Trauma), thus is important. Sonography was conducted to precisely diagnose and detect renal injuries caused by blunt abdominal trauma. Ultrasonography is also useful in detecting injuries and it is less value in evaluating those with suspected extraperitoneal injury. In some cases, MRI, Renal angiogram and scintigraphy may be useful.

In our case, an adolescent boy with fall from bicycle sustaining blunt abdominal trauma in September 2023 with Gr-IV injury to right kidney is under observation as hemodynamically stable.

No Pediatric renal trauma guidelines have been established though children are at higher risk of renal injury from blunt trauma than adults.