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Med J Bakirkoy. 2006; 2(3): 97-100


Our clinical approach in patients with renal injury

Volkan Tuğcu, Selçuk Şahin, Bedi Özbay, Muzaffer Baş, Serdar Karadağ, Bekir Aras, Ali İhsan Taşçı.

Abstract
Objective: We aimed to evaluate our clinical approach in patients with renal ınjury.
Material and Methods: Eighteen patients who had attended to our clinic with renal trauma between 2002 and 2006 were included in this
study.
Results: Mean age of the patients was 25.6±8.4 years and female/male ratio was 1/17. When etiologic causes were evaluated, 10 patient
had penetrating trauma (8 stab wounds and 2 gunshot wounds) and 8 patients had blunt trauma (4 pedestrian accidents, 2 falls from
height, 1 motor-vehicle accident and 1 fall from bicycle). Abdominal computerized tomography with i.v. contrast was obtained for all
patients prior to hospitalization. According to American Association of Trauma Surgery Organ Injury Scale, 2, 3, 4, 7 and 2 of the patients
had grades 1, 2, 3, 4 and 5 injuries, respectively. All patients with grades 1-3 injuries and 6 patients with grade 4 injury were managed
conservatively. Partial nephrectomy was performed in one patient with grade 4 renal injury and nephrectomy was performed in 2 patients
with grade 5 renal injury. It was observed that renal functions of a patient with grade 4 renal injury, who was managed conservatively,
were progressively decreased.
Conclusion: Patients with grades 1-3, even grade 4 renal injury can recover after conservative management. Conservative management
should be thought at the first hand in hemodynamically stable patients.

Key words: Renal trauma, conservative management, nephrectomy



Böbrek Yaralanması Olan Hastalarda Klinik Yaklaşımımız

Özet
Amaç: Bu çalışmamızda böbrek yaralanması olan hastalara klinik yaklaşımımızı değerlendirdik.
Gereç ve Yöntem: 2002-2006 yılları arasında böbrek yaralanması nedeniyle kliniğimize başvuran 18 hasta çalışmaya dahil edildi.
Bulgular: Olguların yaş ortalaması 25.6±8.4, kadın/erkek oranı 1/17 idi. Hastaların etyolojileri incelendiğinde 10’unda penetran (8 delici-kesici
alet yaralanması, 2 ateşli silah yaralanması), 8’inde künt (4 araç dışı trafik kazası, 2 yüksekten düşme, 1 araç içi trafik kazası,1 bisikletten
düşme) travma tespit edildi. Bütün hastalara hospitalizasyon öncesi intravenöz kontrastlı bilgisayarlı abdominal tomografi çekildi. Travmaları
n Amerikan Travma Cerrahisi Birliği Organ Yaralanma Skalası’na göre 2’si grade 1, 3’ü grade 2, 4’ü grade 3, 7’si grade 4 ve 2’si grade
5 idi. Grade 1-3 yaralanmalı hastaların hepsi ve grade 4 yaralanmalı hastaların 6 tanesi konservatif tedavi edildi. Grade 4 renal yaralanmalı
1 hastaya parsiyel nefrektomi, grade 5 yaralanmalı 2 hastaya nefrektomi yapıldı. Konservatif tedavi edilen grade 4 travmalı bir hastanın
kontrollerinde böbrek fonksiyonlarının ileri derecede azaldığı gözlendi.
Sonuç: Renal travmalı hastalardan grade 1-3 hatta 4 olanlar konservatif tedavi ile düzelebilmektedir. Hemodinamik olarak stabil hastalarda
konservatif tedavi öncelikli olarak denenmelidir.

Anahtar Kelimeler: Renal travma, konservatif tedavi, nefrektomi



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