Management of Pediatric Grade IV Renal Trauma

Gregory P Murphy¹, Thomas W Gaither¹, Mohannad A Awad^{1

2}, E Charles Osterberg³, Nima Baradaran⁴, Hillary L Copp¹, Benjamin N Breyer^{5

6

7}

Affiliations

¹ Department of Urology, University of California-San Francisco, San Francisco, CA, USA.
² Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia.
³ Department of Urology, Dell Medical School, University of Texas, Austin, TX, USA.
⁴ Department of Urology, Medical University of South Carolina, Charleston, USA.
⁵ Department of Urology, University of California-San Francisco, San Francisco, CA, USA. Benjamin.Breyer@ucsf.edu.
⁶ Department of Biostatistics and Epidemiology, University of California - San Francisco (UCSF), San Francisco, CA, USA. Benjamin.Breyer@ucsf.edu.
⁷ Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Suite 3A, San Francisco, CA, 94110, USA. Benjamin.Breyer@ucsf.edu.

PMID: 28233229
DOI: 10.1007/s11934-017-0665-z

Free article

Review

Management of Pediatric Grade IV Renal Trauma

Gregory P Murphy et al. Curr Urol Rep. 2017 Mar.

Free article

. 2017 Mar;18(3):23.

doi: 10.1007/s11934-017-0665-z.

Authors

Gregory P Murphy¹, Thomas W Gaither¹, Mohannad A Awad^{1

2}, E Charles Osterberg³, Nima Baradaran⁴, Hillary L Copp¹, Benjamin N Breyer^{5

6

7}

Affiliations

¹ Department of Urology, University of California-San Francisco, San Francisco, CA, USA.
² Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia.
³ Department of Urology, Dell Medical School, University of Texas, Austin, TX, USA.
⁴ Department of Urology, Medical University of South Carolina, Charleston, USA.
⁵ Department of Urology, University of California-San Francisco, San Francisco, CA, USA. Benjamin.Breyer@ucsf.edu.
⁶ Department of Biostatistics and Epidemiology, University of California - San Francisco (UCSF), San Francisco, CA, USA. Benjamin.Breyer@ucsf.edu.
⁷ Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Suite 3A, San Francisco, CA, 94110, USA. Benjamin.Breyer@ucsf.edu.

PMID: 28233229
DOI: 10.1007/s11934-017-0665-z

Abstract

Purpose of review: Review the current literature regarding the management of grade IV renal injuries in children.

Recent findings: Children are at increased risk for renal trauma compared to adults due to differences in anatomy. Newer grading systems have been proposed and are reviewed. Observation of most grade IV renal injuries is safe. Operative intervention is necessary for the unstable patient to control life-threatening bleeding with either angioembolization or open exploration. Symptomatic urinomas may require percutaneous drainage and/or endoscopic stent placement. Ureteropelvic junction (UPJ) disruption, seen more often in children, requires immediate surgical repair. Grade IV renal injuries in children are increasingly managed in a conservative manner.

Keywords: Grade IV laceration; Pediatric; Renal trauma.

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References

1. J Urol. 2008 Jun;179(6):2248-52; discussion 2253 - PubMed
1. J Trauma. 2011 Jan;70(1):35-7 - PubMed
1. J Urol. 2011 Apr;185(4):1316-20 - PubMed
1. World J Urol. 2014 Jun;32(3):821-7 - PubMed
1. J Trauma. 1989 Dec;29(12):1664-6 - PubMed

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Management of Pediatric Grade IV Renal Trauma

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Management of Pediatric Grade IV Renal Trauma

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