Çocuklarda Böbrek Yaralanması

Amaç: Bu çalışmada çocuklarda renal travma deneyimimizi sunmayı amaçladık. Gereç ve Yöntem: Ocak 2003 - Aralık 2012 tarihleri arasında renal travma nedeniyle tedavi edilen 25 hasta geriye dönük olarak incelendi. Bulgular: Hastaların 15’i (%60) erkek, 10’u (%40) kız ve yaş ortancası 9.1 (3 yaş-15 yaş) idi. Hepsi künt yaralanmalardı ve 11’i (%44) yüksekten düşme, 8’i (%32) araç dışı trafik kazası, 3’ü (%12) araç içi trafik kazası, 2’si (%8) at tepmesi ve 1’i (%4) attan düşme ile oluşmuştu. 17’sinde (%68) makroskopik, 2’sinde (%8) mikroskopik hematüri vardı, 6’sında (%24) hematüri yoktu. Sadece 6 olguda US tanımlayıcı iken BT hepsinde yaralanmayı tanımladı. Yaralanmanın 15’i (%60) sağ, 10’u (%40) sol taraftaydı. Altısında (%24) G1, 4’ünde (%16) G2, 4’ünde (%16) G3, 7’sinde (%28) G4 ve 4’ünde (%16) G5 yaralanma vardı. Altı hastaya hemodinamik stabilite sağlanamadığı için cerrahi uygulandı ve hepsi nefrektomi ile sonuçlandı. Grade 4 yaralanması olan bir hastaya JJ kateteri, bir hastaya perkütan nefrostomi uygulandı. Hastanede kalış süresi ortalama 9.3 (3 gün-23 gün) gündü ve mortalite görülmedi. Hastalar yıllık nefroloji kliniği kontrolüne alındı. Sonuç: Hematüri; renal travmaların önemli bir bulgusudur, mutlaka ileri tetkik ile incelenmelidir. Hemodinamisi stabil olduğu sürece hiçbir hastaya cerrahi müdahale yapılmamalıdır. Cerrahi müdahale nefrektomi olasılığını yükseltir. Ürinom gelişen hastalarda perkütan nefrostomi katateri veya JJ katateri ile ürinom boşaltılmalıdır. Çocuk,

Renal Trauma in Children

Objective: In this study, we aimed to present our renal trauma experience in children. Material and Method: Twenty-five children treated because of renal trauma, between January 2003 and December 2012, were evaluated retrospectively. Results: Fifteen patients were male (60 %), 10 were female (40 %) and the average age was 9.1 (3 years – 15 years). All of them were blunt traumas and 11 cases (44 %) were falling down from height, 8 cases (32 %) were pedestrian traffic accidents, 3 cases (12%) were vehicle accidents, 2 cases (8 %) were horse kicks and 1 case (4 %) was falling off a horse. Macroscopic hematuria in 17 cases (68 %) and microscopic hematuria in 2 cases (8 %) were observed and in 6 cases (24 %) there were no hematuria. While US was descriptive for only 6 cases, BT described the trauma in all of them. The trauma was located on the right kidney in 15 cases (60 %) and on the left kidney in 10 cases (40 %). 6 cases (24 %) had G1, 4 cases (16%) had G2, 4 cases (16 %) had G3, 7 cases (28 %) had G4 and 4 cases (16 %) had G5 trauma. Since hemodynamic stability could not be maintained by six patients, surgery was applied and all resulted in nephrectomy. A patient with G4 trauma was applied JJ catheter and percutaneous nephrostomy was applied to a patient. The average hospitalization period was 9.3 (3 days – 23 days) days and mortality did not occur. The patients were taken into nephrology control annually. Conclusions: Hematuria is an important finding of renal traumas and it must be evaluated by advanced examinations. Any hemodynamically stable patients should not have an operation. Surgical intervention increases the possibility of nephrectomy. In patients developing urinoma, urinoma needs to be drained by percutaneous nephrostomy or JJ catheter.

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