The Medical Journal of Basrah University

Abstract

ABSTRACT
Background: About 10% of all injuries seen in the emergency room involve the genitourinary system to some
extent. Renal injuries are the most common injuries of the urinary system. A blunt trauma directed to the abdomen,
flank, or back is the most common mechanism. A kidney with a pre-existing abnormality is at increased risk for
injury. The objective of the study is early detection of intraperitoneal rupture of the kidney in cases of acute abdomen
and also to confirm the fact that the severity of patients' symptoms is disproportionate to the degree of injury in
children suffering from renal abnormalities.
Patients & methods: A total of 15 patients were included in the study from 2004-2009. The age range was 3-13
years. Five patients were girls & ten were boys. A brief history was taken and a thorough physical examination was
done. Hemoglobin, packed cell volume and urinalysis were done. Imaging by ultrasonography and computerized
tomography (CT) with contrast were done in these patients. Emergency laparotomy was performed in all patients.
Results: Intraperitoneal rupture of the kidney with urine peritonitis (uroperitoneum) was found in all patients.
Seven patients had left sided renal injuries while eight patients had right sided injuries. A thin renal parenchyma with
extravasation of contrast media into the peritoneal cavity were found in CT of all patients. Nephrectomy was the
decided surgical treatment in every patient.
Conclusion: It can be concluded that children with hydronephrotic kidneys are more prone to intra-peritoneal
rupture from minor trauma and a high index of suspicion is needed to diagnose those patients with intraperitoneal
rupture of the kidney.