ETIOLOGY, IMAGING FINDINGS, AND TREATMENT OUTCOMES IN RENAL TRAUMA PATIENTS AT CHO RAY HOSPITAL

Abstract

Background: Renal trauma is a common urological emergency, especially in developing countries where motorcycle-related accidents are prevalent. In recent years, advances in non-operative management, including interventional radiology and intensive care, have significantly reduced the need for surgery and nephrectomy.

Objectives: To evaluate the clinical characteristics, imaging findings, and treatment outcomes of patients with renal trauma managed at Cho Ray Hospital.

Methods: We conducted a retrospective descriptive study of 686 patients with blunt renal trauma treated at Cho Ray Hospital from January 2019 to December 2022. Patients with penetrating injuries or prior renal exploration were excluded. Clinical features, imaging results, injury grading (AAST 2018), and treatment modalities were analyzed. Data were processed using SPSS 20.

Results: The majority of patients were male (83%) with a mean age of 38.04 ± 14.34 years. Road traffic accidents, particularly involving motorcycles, were the leading cause (76.4%). Grade III and IV injuries were most common (33.2% and 29.3%, respectively). Computed tomography was performed in all cases, with perirenal hematoma (76.7%) and renal parenchymal laceration (53.9%) being the most frequent findings. Non-operative management was successful in 81.8% of cases, including many high-grade injuries. Angioembolization was performed in 9.0% of patients, while surgery was reserved for hemodynamically unstable cases or those with underlying renal abnormalities.

Conclusions: Renal trauma predominantly affects young males in traffic-related accidents. Conservative management is highly effective even for severe injuries (grade IV–V) when hemodynamic stability is maintained. Selective angioembolization has significantly reduced the need for surgery. However, surgical intervention remains crucial in certain high-risk or complex cases.

Keywords: renal trauma; non-operative management; angioembolization; urological surgery; nephrectomy