Renal Trauma

Renal Trauma

Q. 1

Which of the following is true about renal trauma‑

 A Urgent IVP is indicated

 B

Exploration of the kidney to be done in all cases

 C

Lumbar approach to kidney is preferred

 D

Renal artery aneurysm is common

Q. 1

Which of the following is true about renal trauma‑

 A

Urgent IVP is indicated

 B

Exploration of the kidney to be done in all cases

 C

Lumbar approach to kidney is preferred

 D

Renal artery aneurysm is common

Ans. A

Explanation:

Ans. is ‘a’ i.e., Urgent IVP is indicated 

  • Approach to kidney should be transperitoneal to exclude the possibility of damage to other abdominal organs. Approach should not be Lumbar.
  • Aneurysm of renal artery is a rare complication -Bailey

Q. 2 All except one are correct regarding renal trauma ‑

 A

Observation is best

 B

IVP is indicated

 C

Exploration indicated in all cases

 D

Haematuria is a cardinal sign

Q. 2

All except one are correct regarding renal trauma ‑

 A

Observation is best

 B

IVP is indicated

 C

Exploration indicated in all cases

 D

Haematuria is a cardinal sign

Ans. C

Explanation:

Ans is ‘c’ ie. Exploration is indicated in all cases 

“Surgical exploration is needed in less than 10 percent of closed injuries and is indicated if either there a signs of progressive blood loss or there is an expanding mass in the loin.”- Bailey 25/e

  • More than 90 percent of all blunt renal injuries are managed conservatively.
  • An IVP is done urgently to assesss the damage to the kidney and to know the functioning of the other kidney.
  • Haematuria is the cardinal sign of a damaged kidney but it may not appear untill some hours after the injury. It is present in more than 95% of pts with renal injury. The degree of hematuria does not precisely correlate with the severity of injury.
  • Closed renal injury is usually extraperitoneal. The exception is seen occasionally in young children who have very little extraperitoneal fat. Their peritoneum is in close contact to the kidney and can tear with the renal capsule leaking blood and urine into the peritoneum.
  • Complications
  • Pararenal pseudohydronephrosis*
  • Hypertension* resulting from renal fibrosis may occur 3 months or more after injury. If is often refractory to medicines and nephrectomy may be necessary.
  • Aneurysm of the renal artery*.

Q. 3 Which does not happen in Unilateral Renal Trauma ‑

 A

Hypertension

 B

Uraemia

 C

Clot formation

 D

Perinephric haematoma

Q. 3

Which does not happen in Unilateral Renal Trauma ‑

 A

Hypertension

 B

Uraemia

 C

Clot formation

 D

Perinephric haematoma

Ans. B

Explanation:

Ans. is ‘b’ i.e., Uraemia 
Clinical features-

  • Hematuria is the most important sign of renal injury.
  • Loin bulge due to perinephric haemtoma.
  • Bruising of soft tissue in the loin.
  • Retroperitoneal haematoma –> abdominal distension.
  • systolic blood pressure ≤90 mmHg

Q. 4 Renal trauma is best treated by –

 A

Observation and supportive measures

 B

Early drainage of perirenal haematoma

 C

Heminephrectomy

 D

Nephrostomy

Q. 4

Renal trauma is best treated by –

 A

Observation and supportive measures

 B

Early drainage of perirenal haematoma

 C

Heminephrectomy

 D

Nephrostomy

Ans. A

Explanation:

Ans. is ‘a’ i.e., Observation and supportive measures 
Treatment-

  • Blunt trauma are treated conservatively
  • Penetrating injuries, small & major lacerations- surgical exploration.

Quiz In Between



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