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Erschienen in:

01.03.2017 | Pediatric Urology (D Weiss, Section Editor)

Management of Pediatric Grade IV Renal Trauma

verfasst von: Gregory P. Murphy, Thomas W. Gaither, Mohannad A. Awad, E. Charles Osterberg, Nima Baradaran, Hillary L. Copp, Benjamin N. Breyer

Erschienen in: Current Urology Reports | Ausgabe 3/2017

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Abstract

Purpose of Review

Review the current literature regarding the management of grade IV renal injuries in children.

Recent Findings

Children are at increased risk for renal trauma compared to adults due to differences in anatomy. Newer grading systems have been proposed and are reviewed. Observation of most grade IV renal injuries is safe. Operative intervention is necessary for the unstable patient to control life-threatening bleeding with either angioembolization or open exploration. Symptomatic urinomas may require percutaneous drainage and/or endoscopic stent placement. Ureteropelvic junction (UPJ) disruption, seen more often in children, requires immediate surgical repair.

Summary

Grade IV renal injuries in children are increasingly managed in a conservative manner.

Heron M. Deaths: leading causes for 2010. Natl Vital Stat Rep. 2013;62:1.PubMed

• Grimsby GM, Voelzke B, Hotaling J, Sorensen MD, Koyle M, Jacobs MA. Demographics of pediatric renal trauma. J Urol. 2014;192(5):1498–502. Excellent study of the epidemiology of renal trauma in children.CrossRefPubMed

• Hussman DA. Chapter 154: Pediatric genitourinary trauma. In: Campbell Walsh Urology: 11th Edition; Wein AJ, Kavoussi LR, Partin AW, Peters CA (EDS), Elsevier-Saunders, Philadelphia, PA. P. 3538. Excellent chapter that summarizes pediatric trauma.

Buckley JC, McAninch JW. Pediatric renal injuries: management guidelines from a 25-year experience. J Urol. 2004;172(2):687–90.CrossRefPubMed

Petrosyan M, Guner YS, Emami CN et al: Disparities in the delivery of pediatric trauma care. J Trauma, suppl., 2009; 67: S114.

• Moore EE, Shackford SR, Pachter HL, et al. Organ injury scaling: spleen, liver, and kidney. J Trauma. 1989;29:1664–6. Original article describing renal trauma grading system.CrossRefPubMed

Buckley JC, McAninch JW. Revision of current American Association for the Surgery of Trauma Renal Injury grading system. J Trauma. 2011;70(1):35–7.CrossRefPubMed

Dugi 3rd DD, Morey AF, Gupta A, Nuss GR, Sheu GL, Pruitt JH. American Association for the Surgery of Trauma grade 4 renal injury substratification into grades 4a (low risk) and 4b (high risk). J Urol. 2010;183(2):592–7.CrossRefPubMed

• Serafetinides E, Kitrey ND, Djakovic N, Kuehhas FE, Lumen N, Sharma DM, et al. Review of the current management of upper urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol. 2015;67(5):930–6. EAU guidelines for urotrauma.CrossRefPubMed

10.

• Morey AF, Brandes S, Dugi 3rd DD, Armstrong JH, Breyer BN, Broghammer JA, et al. Urotrauma: AUA guideline. J Urol. 2014;192(2):327–35. AUA guidelines for urotrauma.CrossRefPubMedPubMedCentral

11.

Santucci RA, Fisher MB. The literature increasingly supports expectant (conservative) management of renal trauma—a systematic review. J Trauma. 2005;59:493.CrossRefPubMed

12.

Santucci RA, McAninch JM. Grade IV renal injuries: evaluation, treatment, and outcome. World J Surg. 2001;25(12):1565–72.CrossRefPubMed

13.

Umbreit EC, Routh JC, Husmann DA. Nonoperative management of nonvascular grade IV blunt renal trauma in children: meta-analysis and systematic review. Urology. 2009;74(3):579–82.CrossRefPubMed

14.

• LeeVan E, Zmora O, Cazzulino F, Burke RV, Zagory J, Upperman JS. Management of pediatric blunt renal trauma: a systematic review. J Trauma Acute Care Surg. 2016;80(3):519–28. Excellent systematic review of the pediatric blunt renal trauma series.CrossRefPubMed

15.

Hotaling JM, Sorensen MD, Smith 3rd TG, Rivara FP, Wessells H, Voelzke BB. Analysis of diagnostic angiography and angioembolization in the acute management of renal trauma using a national data set. J Urol. 2011;185(4):1316–20.CrossRefPubMedPubMedCentral

16.

Breyer BN, McAninch JW, Elliott SP, Master VA. Minimally invasive endovascular techniques to treat acute renal hemorrhage. J Urol. 2008;179(6):2248–52.CrossRefPubMed

17.

Glass AS, Appa AA, Kenfield SA, Bagga HS, Blaschko SD, McGeady JB, et al. Selective angioembolization for traumatic renal injuries: a survey on clinician practice. World J Urol. 2014;32(3):821–7.CrossRefPubMed

18.

Schuster T, Leissner G. Selective angioembolization in blunt solid organ injury in children and adolescents: review of recent literature and own experiences. Eur J Pediatr Surg. 2013;23(6):454–63.CrossRefPubMed

19.

Au JK, Tan X, Sidani M, Stanasel I, Roth DR, Koh CJ, Seth A, Gargollo PC, Tu D, Gonzales ET, Smith TG 3rd, Janzen N. Imaging characteristics associated with failure of nonoperative management in high-grade pediatric blunt renal trauma. J Pediatr Urol. 2016 Oct;12(5):294.e1-294.e6.

20.

Eassa W, El-Ghar MA, Jednak R, El-Sherbiny M. Nonoperative management of grade 5 renal injury in children: does it have a place? Eur Urol. 2010;57(1):154–61.CrossRefPubMed

21.

He B, Lin T, Wei G, He D, Li X. Management of blunt renal trauma: an experience in 84 children. Int Urol Nephrol. 2011;43(4):937–42.CrossRefPubMed

22.

Russell RS, Gomelsky A, McMahon DR, Andrews D, Nasrallah PF. Management of grade IV renal injury in children. J Urol. 2001;166(3):1049–50.CrossRefPubMed

23.

Lee JN, Lim JK, Woo MJ, Kwon SY, Kim BS, Kim HT, et al. Predictive factors for conservative treatment failure in grade IV pediatric blunt renal trauma. J Pediatr Urol. 2016;12(2):93. e1-7.CrossRefPubMed

24.

• Bryk DJ, Zhao LC. Guideline of guidelines: a review of urological trauma guidelines. BJU Int. 2016;117(2):226–34. Nicely compares and contrasts all urotrauma guidelines.CrossRefPubMed

25.

Henderson CG, Sedberry-Ross S, Pickard R, Bulas DI, Duffy BJ, Tsung D, et al. Management of high grade renal trauma: 20-year experience at a pediatric level I trauma center. J Urol. 2007;178(1):246–50.CrossRefPubMed

26.

Mohamed AZ, Morsi HA, Ziada AM, Habib EM, Aref AM, Kotb EA, et al. Management of major blunt pediatric renal trauma: single-center experience. J Pediatr Urol. 2010;6(3):301–5.CrossRefPubMed

27.

Moog R, Becmeur F, Dutson E, Chevalier-Kauffmann I, Sauvage P, Brunot B. Functional evaluation by quantitative dimercaptosuccinic acid scintigraphy after kidney trauma in children. J Urol. 2003;169(2):641–4.CrossRefPubMed

Titel: Management of Pediatric Grade IV Renal Trauma
verfasst von: Gregory P. Murphy
Thomas W. Gaither
Mohannad A. Awad
E. Charles Osterberg
Nima Baradaran
Hillary L. Copp
Benjamin N. Breyer
Publikationsdatum: 01.03.2017
Verlag: Springer US
Erschienen in: Current Urology Reports / Ausgabe 3/2017
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-017-0665-z

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Management of Pediatric Grade IV Renal Trauma