DIAGNOSTICS AND TREATMENT OF CLOSED KIDNEY INJURY: 20-YEAR EXPERIENCE OF THE FERGANA BRANCH OF RSCEMP

А.Ю. Тухтакулов , Б.А. Туйчиев , Б.М. Ахраров , У.М. Маткаримов

Abstract

Aim. Systematization of the experience of the Fergana branch of the RRCEM on the management of victims with
isolated and concomitant closed kidney injury.
Material and methods. The study included 52 patients with closed kidney injury, hospitalized in the Fergana
branch of the RRCEM in the period 2001-2020. Kidney damage was established taking into account the clinical
picture and the results of ultrasound and MSCT. In determining the severity of kidney injury, the American
Association for Surgical Injury Scale (AAST) Kidney Injury Scale was followed.
Results. Conservative treatment was effective in all 23 (100%) patients with grade I kidney damage and in
11 (91.7%) of 12 patients with grade II lesion. In all 8 (100%) cases of kidney injury with grade III lesion and
in 4 (66.7%) cases out of 6 with grade IV injury, organ-preserving surgery was performed. Indications for
nephrectomy appeared only in 5 (9.6%) patients out of 52, when IV and V degrees of kidney damage took place.
Conclusion. In hemodynamically stable patients without clinical, ultrasound and MSCT signs of ongoing
bleeding with kidney damage of I-IV degrees according to the AAST scale, conservative treatment can be carried
out. After the completion of the process of equipping the RRCEM and its regional branches with angiographic
complexes, new prospects will open up for further improving the results of conservative treatment of kidney
injury by including endovascular methods of hemostasis in the treatment standards.