OPTIMAL RENAL PRESERVATION WITH TIMELY PERCUTANEOUS INTERVENTION - A CHANGING CONCEPT IN THE MANAGEMENT OF BLUNT RENAL TRAUMA IN CHILDREN IN THE 1990S

Objective To report the results of treatment of 132 children with blun t renal trauma and indicate our treatment recommendations. Results Bet ween 1971 and 1991 132 children presented with blunt renal trauma. Gra de I injuries (renal contusion) were seen in 97 children, grade II inj uries (renal laceration) in 32 and grade III (shattered kidney and ped icle injury) in three. Twenty-six children with grade II injuries were treated non-surgically. Urinomas developed in three, which were drain ed percutaneously with complete resolution. Prior to 1985 six patients with grade II injuries underwent total or partial nephrectomy for maj or renal lacerations. Repair of shattered kidneys resulted in signific ant morbidity. Conservative management of major blunt injuries with ju dicious percutaneous intervention resulted in no renal loss. Conclusio n We believe that conservative therapy with timely percutaneous draina ge of urinomas in children with major blunt renal injury, other than s hattered kidney or pedicle injuries, optimizes renal preservation and minimizes secondary complications.