Renal Trauma
Violent impacts in the lumbar area, such as those caused by motor vehicle accidents and falls from great heights by, can cause severe kidney damage.
causes
Renal injury may be caused by any type of impact on the lower back with sufficient intensity to damage directly or indirectly kidneys.
They may be a direct injury, ie, the impact of a blunt object on the lumbar area, causing lowering of the ribs and consequential compression of kidney or rupture. Although the most frequent causes of these impacts are traffic accidents, renal injuries can also be caused by blows or shocks with any sharp object.
Another mechanism capable of causing renal damage is the kickback, or a sudden acceleration and deceleration movement which displaces the kidney from one side to the other. The most frequent causes of such injuries are falls from a height, for example, from the top of a balcony or a staircase. In such cases, the sudden interruption of the fall, when the body hits the ground, the traction causes a sudden large blood vessels leading to and from the kidney, and there may be a break and / or release.
Another production mechanism of kidney injury represents a deep wound in the lower back caused by sharp or pointed object to reach the kidney tissue. Obviously, the most frequent causes of these injuries are wounds caused by firearms or melee weapons (knives, razors, etc.).
types
According to the nature and intensity of the impact, and also depending on the severity of the injury, and can distinguish various types of renal trauma:
Minor injuries in the kidney, as the impact is not too violent, and not the function of damaged kidneys. The most common type of kidney injury reduced renal injury, wherein although breakage of some small blood vessels of the body, its capsule remains intact, so that the hematoma formation or accumulation of blood takes place under the renal capsule . On the other hand, small surface cracks or tears in the renal capsule are also considered minor renal injuries.
In moderate renal injury, although the function of the kidneys suffer some changes, they may be overcome if appropriate to proceed to his treatment. The type most characteristic lesion of moderate kidney injury and disruption of the renal capsule. In this case, blood from the affected tissue accumulates outside the rim, providing the formation of a perirenal hematoma. Another usual trauma injury in moderate renal cortical and deep lacerations, or the disruption of the renal cortex. In this case, the rupture of the wall of the renal calices causes the urine is poured into the perirenal tissues.
Finally, severe kidney trauma causes severe acute renal failure, which can be irreversible if not proceed to immediate treatment. The most common type of injury in severe renal trauma and the so-called fragmented kidney, in which the body is divided into several parts. Another type of serious injury and disruption of the renal pedicle, namely the breakdown of the blood vessels supplying the organ and contribute to fixation.
manifestations
The manifestations may be very varied and do not always reflect the severity of injury, at least in the beginning.
The most common symptoms and low back pain, which is located at the bottom or side of the back. The intensity and duration delta pain are highly variable. In mild injuries, the pain is usually very intense and usually resolves spontaneously after a few days. By contrast, in moderate or severe injuries, often very intense. In addition, the production of bleeding around the kidneys, causes an involuntary bending and characteristics of the patient's own legs, in order to decrease the same.
Another common manifestation in renal trauma and hematuria, ie the loss of blood in the urine. Sometimes the hemorrhage detected by the reddish-colored urine; in other cases, as evidenced by the presence of blood clots, usually large, being formed inside the ureters. The hematirria may manifest immediately or only one or two days after violent impact caused the injury, which does not imply that injuries are less severe. In fact, blocked by a clot and the consequent obstruction of the urinary tract can lead to renal colic and urinary retention due to lack of voids.
Finally, in the most serious cases, the sudden loss of blood caused by a kidney injury can give rise to cardiovascular shock, manifested by the patient very pale color and the apparent acceleration of the wrist. Furthermore, if internal bleeding is very severe, the patient's life may be in danger.
Additional Information
Diagnosis and treatment
Doctors usually diagnose the existence of a renal injury when there are clear history of impact in the lumbar region or when they detect an open wound that area. Anyway, the most important thing is to make an assessment of the damage and the consequences of trauma, a key to determine the appropriate therapeutic action point. For this, radiological and ultrasound examinations and, in some cases, an arteriogram or computed tomography should be performed. Sometimes, the patient should be hospitalized until they get the test results, because before these can not always accurately determine the severity of the situation.
Mild Renal injury does not require a special treatment in addition to the administration of analgesics to relieve pain, and rest to promote rapid healing of the lesions. In moderate and severe injuries, taking into account that it is necessary to monitor the functioning of the kidneys and resolve any immediate problem, it is customary to hospitalize the patient for surveillance. In some cases, especially in severe trauma, it may be necessary to use several types of surgical techniques to repair damaged tissues and / or extract bruises or blood clots formed inside or outside the kidney. Sometimes, surgery is an emergency situation which may depend on the future functioning of the kidneys and the patient's life.
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