kidney damage
Introduction
Introduction to kidney damage The kidneys are deeper and have protection from the fat sac and surrounding tissue structure, with fewer chances of injury. Kidney damage is mostly caused by firearm injuries, stab wounds and local direct or indirect violence. According to the degree of trauma, it is divided into four types: contusion, laceration, laceration and kidney injury. Kidney damage accounts for about 65% of all genitourinary tract injuries. basic knowledge The proportion of illness: 0.005% - 0.008% Susceptible people: no specific population Mode of infection: non-infectious Complications: Hemorrhagic shock
Cause
Cause of kidney damage
Violence (30%):
The direct violence of the kidney area was directly hit, and the wounded fell on a hard object or squeezed between two foreign violence. When an indirect violent person falls from a height, his feet or hips touch the ground and hurt the kidneys due to severe vibration. When an indirect violent person falls from a height, his feet or hips touch the ground and hurt the kidneys due to severe vibration.
Puncture injury (20%):
Often a penetrating injury can damage the whole kidney or one of them, usually accompanied by abdominal or other visceral injuries in the chest. Blunt injury (80%), penetrating injury (increased during war and high crime areas), and iatrogenic injury (due to surgery, extracorporeal shock wave lithotripsy or renal biopsy). Complications include bleeding, extravasation, abscess formation, and high blood pressure.
Spontaneous ruptured kidney (20%):
It can also spontaneously rupture without significant external violence. This type of "spontaneous" renal rupture is often caused by kidney lesions such as hydronephrosis, tumors, stones and chronic inflammation.
Prevention
Kidney damage prevention
Pay attention to life safety and no effective preventive measures.
Complication
Kidney damage complications Complications, hemorrhagic shock
Shock: Severe injuries, hemorrhagic shock can occur when bleeding occurs.
Symptom
Symptoms of kidney damage Common symptoms Trauma, proximal convoluted tubules, extravasation, extravasation, urinary shock
1. There is a lower rib fracture, lumbar pain and lumbar muscle tension after lumbar trauma. More with mesh eye urine, kidney pedicle fracture can be no hematuria. Open wounds can ooze urine from the wound.
2, local mass: a lumps on the injured side of the waist or abdomen.
3, shock: serious injury, bleeding can occur when hemorrhagic shock.
4, hematuria: most patients have this symptom, the amount of hematuria is proportional to the extent and extent of kidney damage. Most of them appear immediately after the injury, but secondary hematuria can occur again within 2 to 3 weeks after the hematuria is stopped.
Examine
Kidney damage examination
1. X-ray examination: the lower rib or lumbar vertebrae fracture can be seen in the abdominal plain film. The shadow of the kidney area is enlarged. The venous pyelography shows that the kidney shape is enlarged, the renal pelvis and renal pelvis filling defect, the kidney is not developed or the contrast agent overflow can confirm the kidney damage. Case.
2, CT examination: can understand the shape of the kidney, the type of injury, the extent of perirenal hematoma and the extent of urinary extravasation.
3, renal artery angiography: can understand the renal blood supply and kidney artery damage or embolism.
Diagnosis
Diagnosis of kidney damage
Diagnosis requires detailed medical history, physical examination, special laboratory tests and X-ray examinations. It is important to identify the mechanism of the injury, any clinical manifestations of kidney damage (such as the impression of a seat belt, lumbar contusion, low rib fracture), initial blood pressure and hematocrit, and hematuria. Diagnosis begins with X-ray examination, close observation or surgical exploration. All patients with hemodynamic stability should undergo radiographic examination to accurately assess the extent of kidney damage. Unless it is a blunt injury, blood pressure is stable, microscopic hematuria and no clinical manifestations of lumbar injury in adult patients.
The choice of imaging examination must be in collaboration with the trauma team and determined by clinical circumstances. Both intravenous urography and CT can provide sufficient information about the kidneys, but CT is more suitable in patients with multiple injuries. The diagnostic role of angiography is attenuated with the appearance of CT, but may help to detect vascular bleeding before embolization.
