Preservation of the kidney with delayed diagnosis of traumatic pelvi-ureteric junction disruption secondary to blunt abdominal trauma in children

Background The delayed diagnosis of pelvi-ureteric junction （PUJ） disruption in children following blunt abdominal trauma can result in loss of function of the involved kidney. We examined the potential for kidney preservation and the limits of diagnostic delays. Methods A retrospective review of 17...

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Bibliographic Details
Published in:Chinese medical journal 2011-08, Vol.124 (15), p.2290-2296
Main Authors: Li, Ming-lei, Sun, Ning, Zhang, Wei-ping, Huang, Cheng-ru, Bai, Ji-wu, Liang, Ruo-xin, Tian, Jun, Xie, Xiang-hui, Song, Hong-cheng, Li, Ning
Format: Article
Language:English
Subjects:
Abdominal Injuries - complications
Abdominal Injuries - surgery
Child
Child, Preschool
Female
Humans
Kidney - injuries
Kidney - surgery
Kidney Pelvis - injuries
Kidney Pelvis - surgery
Male
Retrospective Studies
Ureter - injuries
Ureter - surgery
Ureteral Obstruction - etiology
Ureteral Obstruction - surgery
中断延迟
交界处
创伤
北京儿童医院
外伤
肾脏
诊断
输尿管
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Summary:Background The delayed diagnosis of pelvi-ureteric junction （PUJ） disruption in children following blunt abdominal trauma can result in loss of function of the involved kidney. We examined the potential for kidney preservation and the limits of diagnostic delays. Methods A retrospective review of 17 cases of PUJ disruption at Beijing Children＇s Hospital from 1993 to 2009 was done with respect to diagnosis, treatment and follow-up. Results The interval from trauma to diagnosis of PUJ disruption was （52＋52） days. If one case with nephrectomy was excluded, the interval from trauma to diagnosis was （40＋_20） days. The average time between injury and first treatment was （49＋_25） days. Pelvi-ureteric reanastomosis and caliceal ureterostomy were performed separately in 11 and 4 patients, respectively. Ileal replacement for ureter injuries was finally performed in one patient. Hydronephrosis of the injured kidney was reduced and the function improved in 15 out of 17 patients （88%）. Only one patient received nephrectomy and the nephrectomy rate was 5.9%. Conclusion Differential renal function at the PUJ disruption side can be saved and the rate of nephrectomy reduced by appropriate surqen/if the time to diaqnosis and first treatment is limited to within two months.
ISSN:0366-6999
2542-5641
DOI:10.3760/cma.j.issn.0366-6999.2011.15.009