Traumatic injuries of retroperitoneal organs: kidney damage due to combined trauma

Abstract

Aim. To improve the results of diagnosis and treatment of victims with injuries of the abdominal cavity and
kidneys with combined trauma.
Material and methods. The study included 66 patients with closed kidney injury with combined trauma
hospitalized in the Namangan branch of the RNCEMP in the яperiod 2013–2020, of whom 48 (72.7%) were
men and 18 (27.3%) were women, aged 10 to 62 years. Kidney damage was determined taking into account the
clinical picture and the results of ultrasound, MSCT and contrast urography. When determining the severity of
kidney injury, the American Association of Surgical Trauma (AAST) kidney injury scale was followed.
Results. Conservative treatment as monotherapy was carried out by 36 (54.5%) victims. Isolated kidney
damage was detected in 24 (36.4%) and combined – in 42 (63.6%) of the victims. Left-sided kidney injury was
noted more often (54.5%) than right-sided (45.5%). In case of damage of III–IV degree with rupture or crushing
of the renal parenchyma in 30 patients, the following surgical interventions were performed: lumbotomy with
suturing of the kidney wound in 9 patients, nephrectomy – 11. With laparotomy, nephrectomy was performed
in 2 patients, revision of paranephral tissue, removal of hematoma in 3 patients. During the revision of the
paranephral hematoma, a rupture of the left renal vein was revealed in one victim, which was sutured by a
team of angiosurgeons.