Hemodynamic Status as a Determinant Variable of Presentation and Management with High-Grade Renal Injuries Hadi Azzawi M.1,*, Mahmood Mohammed Majeed2 1Department of Surgery, Tikrit Medical College, Tikrit University, Tikrit, Iraq 2M.B.Ch.B. Salahaddin General Hospital, Tikrit, Iraq *Corresponding author: Dr. Azzawi M. Hadi, M.B.Ch.B. F.I.B.M.C Urology, Department of surgery, Tikrit medical college, Tikrit University, Tikrit - Iraq. E-mail: azzawy.mustafa@tu.edu.iq
Online published on 25 July, 2019. Abstract Background Renal injury is considered an important cause of significant mortality and morbidity at trauma centers worldwide. It occurs in up to 5% of all trauma patients and accounts for 10 – 25% of traumatic abdominal organ injuries. The kidney is the most common injured organ in the urinary system in both adult and pediatric patients which comprises about 65% of urological trauma. The aim of the study: To evaluate the Hemodynamic condition as a determinant variable in presentation and management of high-grade renal trauma. Patients and Method This cross-sectional analytic study included 36 patients with high-grade renal injury. The diagnosis of renal injury was based on the patient's history, findings on physical examination and different radiological studies. Results Adult male patients with renal injury were prevalent in this study. Penetrating renal injury constituted 52.8% of patients, 69.4% of patients were hemodynamically unstable at the time of admission and hematuria presented in 97.2%. Urinalysis was done for 16.7% while PCV/Hb, blood group and Rh, blood urea and serum creatinine were done in all studied patients. Focused abdominal sonography for trauma was done for 66.7% of patients, contrast CT scan was done for 38.9% of patients, IVU was done for 8.33% of stable patients only while intraoperative single shot IVU was not done for any of the studied patients. The majority of renal injury was grade IV (66.7%). Left side renal trauma constituted 52.8% and associated organ injuries were presented in 72.2%. Operative management was necessary and represented 91.7% of patients, from those, 48.5% were managed with nephrectomy. Reimaging was done for 6 patients only. Top Keywords Trauma, Renal injury, Hemodynamic condition. Top |