BLUNT TRAUMA OF PATHOLOGICAL KIDNEY - RET ROSPECTIVE STUDY OF 34 CASES

The authors report a retrospective study of 34 cases of blunt renal tr auma affecting a pathological kidney out of a total of 156 cases of re nal trauma. The patients were between the ages of 3 and 60 years, with a male predominance (sex-ratio: 2.4). The predominant cause of trauma was a household accident, in 15 cases (44%). The clinical features we re dominated by haematuria and pain. The underlying renal disease was dominated by renal stones (15 cases, 44%) and ureteropelvic junction ( UPJ) abnormality (10 cases, 29%). Twelve patients with benign trauma a nd minimal underlying renal disease were treated conservatively. Surge ry was indicated in the remaining 22 patients, but only 20 were actual ly operated. Nephrectomy was performed in 9 patients and partial nephr ectomy was performed in 3 patients. Treatment consisted of UPJ plasty in 2 cases, uretero-caliceal anastomosis in one case, stone surgery in 4 cases and suture of ruptured renal pelvis in one case. The postoper ative course was marked by the development of a urinary fistula in 1 p atient, cured by drainage and deterioration of hydronephrosis in one p atient. Lastly, one patient died from Wilms' tumour. This disease ther efore tends to have a fairly benign course, which nevertheless depends on the underlying renal disease.