Traumatic Blunt Force Renal Injury in a Diseased Horseshoe Kidney with Successful Embolization to Treat Active Bleeding: A Case Report and Literature Review
Joint Authors
Krutsri, Chonlada
Singhatas, Pongsasit
Sumpritpradit, Preeda
Chaijareenont, Chunlaches
Viseshsindh, Wit
Thampongsa, Tharin
Choikrua, Pattawia
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-07-25
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
Blunt force injuries in patients with preexisting kidney disease account for 19% of all kidney injuries, suggesting that diseased kidneys are more vulnerable than normal kidneys.
When a horseshoe kidney (a rare anomaly: prevalence of 0.2%) is injured, treatment is challenging, especially when nonoperative management is desired.
In high-grade blunt force normal kidney injury, nonoperative management has high succession rate (94.8%) with kidney-related complication (13.6%).
Surgical reconstruction and preservation of a damaged horseshoe kidney is difficult because of variations in its vascular anatomy.
We report successful nonoperative management of a blunt horseshoe kidney injury with active bleeding and review previous outcomes and complications.
Case Presentation.
A 57-year-old man had a head-on collision motorcycle road traffic accident.
On arrival, blood pressure was 90/60 mmHg, pulse rate 140 bpm, and clear yellow urine output 200 ml.
The patient was transiently responsive to fluid and blood component.
Whole body computed tomography showed a high-volume retroperitoneal hematoma and multiple-lacerated lower pole of the kidney, compatible with preexisting horseshoe kidney disease with active contrast-enhanced extravasation from the accessory right renal artery.
Embolization was performed.
Renal function, transiently impaired after embolization, normalized on day 3.
An infected hematoma found on day 7 was successfully controlled with antibiotics.
His recovery was uneventful.
At the 6-month follow-up, his serum creatinine level had returned to normal.
The average age of blunt force horseshoe kidney injury is 31.75 years and occurred more common in male (87.5%).
Conclusion.
Diseased horseshoe kidneys are prone to injury even with low-velocity impact such as a road traffic accident speed<15 km/h.
Embolization is considered the first choice for management, with its high clinical success rate leading to less need for surgical repair.
Not removing a hematoma is likely to result in complications.
If embolization fails to stop bleeding, life-saving surgical exploration should be mandated.
American Psychological Association (APA)
Krutsri, Chonlada& Singhatas, Pongsasit& Sumpritpradit, Preeda& Chaijareenont, Chunlaches& Viseshsindh, Wit& Thampongsa, Tharin…[et al.]. 2020. Traumatic Blunt Force Renal Injury in a Diseased Horseshoe Kidney with Successful Embolization to Treat Active Bleeding: A Case Report and Literature Review. Case Reports in Urology،Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1151905
Modern Language Association (MLA)
Krutsri, Chonlada…[et al.]. Traumatic Blunt Force Renal Injury in a Diseased Horseshoe Kidney with Successful Embolization to Treat Active Bleeding: A Case Report and Literature Review. Case Reports in Urology No. 2020 (2020), pp.1-6.
https://search.emarefa.net/detail/BIM-1151905
American Medical Association (AMA)
Krutsri, Chonlada& Singhatas, Pongsasit& Sumpritpradit, Preeda& Chaijareenont, Chunlaches& Viseshsindh, Wit& Thampongsa, Tharin…[et al.]. Traumatic Blunt Force Renal Injury in a Diseased Horseshoe Kidney with Successful Embolization to Treat Active Bleeding: A Case Report and Literature Review. Case Reports in Urology. 2020. Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1151905
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1151905