TY - JOUR
T1 - How to manage delayed high-grade kidney trauma on pediatric and its complications
T2 - A case report
AU - Rahmatika, Nadya
AU - Wirjopranoto, Soetojo
AU - Soetojo, Bagus Wibowo
AU - Azmi, Yufi Aulia
AU - Putra, Antonius Galih Pranesdha
AU - Soetanto, Kevin Muliawan
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/3/1
Y1 - 2025/3/1
N2 - Introduction and importance: Trauma results in more deaths in childhood than all other causes combined, one of which is high kidney trauma. This case report presents minimally invasive management of high-grade kidney trauma in pediatrics. Case presentation: A 5-year-old boy was referred on day 10 for blunt abdominal trauma. The complaint was intermittent high fever and right back pain after falling from the bike. There are no open wounds. A 9 × 7 cm cystic mass is palpable in the upper right abdominal quadrant. The results of the Abdominal Computed Tomography (CT) scan revealed AAST Grade V kidney trauma with a gap of 3.9 cm, free perirenal fluid on the right side inside the Gerota fascia, and a fluid size of 9.7 × 6.7 × 7.4 cm, with a volume of 256 ccs (HU 8 to 12). Retrograde pyelography (RPG) was performed on the right kidney, contrast extravasation was found, a Double J (DJ) stent was inserted, and percutaneous urinal drainage was performed under ultrasound guidance. Clinical discussion: A CT scan can be used as a detection tool for cases of neglected high-grade kidney trauma. Minimal invasive management can be performed when the patient is in stable condition. Haematuria, fever, and urinoma can be found as a complication. Conclusion: In cases of blunt abdominal trauma in children, there should be suspicion of kidney trauma until the diagnosis is established. If there is a urinoma, installing a DJ Stent and percutaneous drainage is an option.
AB - Introduction and importance: Trauma results in more deaths in childhood than all other causes combined, one of which is high kidney trauma. This case report presents minimally invasive management of high-grade kidney trauma in pediatrics. Case presentation: A 5-year-old boy was referred on day 10 for blunt abdominal trauma. The complaint was intermittent high fever and right back pain after falling from the bike. There are no open wounds. A 9 × 7 cm cystic mass is palpable in the upper right abdominal quadrant. The results of the Abdominal Computed Tomography (CT) scan revealed AAST Grade V kidney trauma with a gap of 3.9 cm, free perirenal fluid on the right side inside the Gerota fascia, and a fluid size of 9.7 × 6.7 × 7.4 cm, with a volume of 256 ccs (HU 8 to 12). Retrograde pyelography (RPG) was performed on the right kidney, contrast extravasation was found, a Double J (DJ) stent was inserted, and percutaneous urinal drainage was performed under ultrasound guidance. Clinical discussion: A CT scan can be used as a detection tool for cases of neglected high-grade kidney trauma. Minimal invasive management can be performed when the patient is in stable condition. Haematuria, fever, and urinoma can be found as a complication. Conclusion: In cases of blunt abdominal trauma in children, there should be suspicion of kidney trauma until the diagnosis is established. If there is a urinoma, installing a DJ Stent and percutaneous drainage is an option.
KW - Case report
KW - High-grade renal trauma
KW - Infection
KW - Pediatric
KW - Urinoma
UR - http://www.scopus.com/inward/record.url?scp=85217887622&partnerID=8YFLogxK
U2 - 10.1016/j.ijscr.2025.111067
DO - 10.1016/j.ijscr.2025.111067
M3 - Article
AN - SCOPUS:85217887622
SN - 2210-2612
VL - 128
JO - International journal of surgery case reports
JF - International journal of surgery case reports
M1 - 111067
ER -