Vivekanandan, G (2008) Evaluation of Epidemiology and Management of Renal Trauma in a Tertiary Care Trauma Centre. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Trauma is non-discriminatory and affects children, adolescents, young adults, pregnant women and the elderly. Trauma is the second leading cause of years of life lost for all people and the leading cause of death and disability for youth and young adults. Despite advances in the technology of motor vehicle safety, motor vehicle collision remains the most common cause of abdominal trauma in this country. Other less frequent sources of blunt trauma to the abdomen includes fall from a height, assaults, bicycle accidents and horse back riding injuries. Of all the genitourinary organs, the kidney is the most likely to be injured in cases of external trauma and injuries to atleast one kidney occur in as many as 10% of abdominal trauma cases. Up to 80% of renal injuries are caused by blunt trauma, mostly motor vehicle accident and most significant renal injuries are associated with other major organ injuries. AIMS AND OBJECTIVES : 1. To study the epidemiology of renal injuries occurring in trauma victims admitted in a tertiary care trauma centre. 2. To analyse the mode of trauma and pattern of renal and associated organ injuries. 3. To evaluate the sensitivity and specificity of various imaging modalities available for studying renal trauma. 4. To evaluate the outcomes of various methods of management of traumatic renal injuries. 5. To study the complications, early and late, associated with renal trauma. 6. To study the morbidity and mortality pattern in renal trauma victims. MATERIALS AND METHODS : The statistical details of all trauma patients who were admitted to the emergency trauma ward in the Govt. General Hospital, Chennai, during the period between January 2006 to March 2008 were analysed and all the patients who sustained renal trauma confirmed by investigations were included in the study. This included renal trauma due to road traffic accidents, train traffic accidents, fall from height, assault and stab injuries. CONCLUSIONS : From the retrospective analysis of this short renal injuries series, though major generalization is not possible ,some valuable facts transpire. Urological injuries are present in upto 20% of patients admitted with abdomainl trauma, hence urologist has a key role in the management of trauma victims. Contrary to the findings of most other studies, posterior uretheral disruption injuries seem to predominate among genitourinary trauma in our study. Young adults in the age group of 16 to 30 years are the most vulnerable to sustain renal injuries. This is due to increasing number of this productive age group’s preference for driving two wheelers. CT scan is the most comprehensive imaging tool to identify and characterize the renal injuries. Non operative management has proven to be successful in majority of the patients sustaining renal trauma. The need for surgical intervention seems to increase with increasing grade of renal injuries. Even penetrating renal trauma, when properly staged can be managed successfully with conservative approach. In this series 2 out of 3 patients with penetrating renal trauma were managed non operatively. The nephrecotmy rate are high when a patient with poly trauma is explored for other concomitant organ injuries.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Epidemiology ; Management ; Evaluation ; Renal Trauma ; Tertiary Care Trauma Centre. |
| Subjects: | MEDICAL > Urology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 09 Aug 2017 04:41 |
| Last Modified: | 09 Aug 2017 04:41 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2533 |
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