Outcome and Management of Blunt Renal Trauma

Introduction: Blunt renal trauma is a significant concern in trauma cases, often resulting from motor vehicle accidents (MVA), falls, assaults, or sports-related injuries. This study aimed to determine the prevalence of blunt renal traumas and evaluate the outcome in patients presenting with renal injuries to Dhaka Medical College Hospital (DMCH). Methods: This observational study was conducted in the Department of Casualty & Urology, Dhaka Medical College and Hospital, Dhaka, Bangladesh, from February 2016 to July 2016. We included 50 patients admitted to the Casualty & Urology Department of our institution with clinical and radiological diagnoses of blunt renal trauma. Results: The most affected age group was 31–40 years (32%), followed by 41–50 years (22%). Males were more commonly affected across all injury grades. MVA was the leading cause (50%), followed by assault (24%) and sports injuries (14%). Macroscopic hematuria (68%) was more common than microscopic hematuria, predominantly seen in Grade III injuries. Management varied by injury severity: Grade I and II injuries were mostly treated conservatively, while higher grades required renorrhaphy, partial nephrectomy, or emergency nephrectomy. Complications occurred in 40% of patients, with sepsis (10 cases) and hemorrhage (6 cases) being the most frequent. One patient with Grade V trauma died. Follow-up compliance was 62%, with 38% of patients not returning for evaluation. Conclusion: Blunt renal trauma predominantly affects middle-aged males, with MVA being the primary cause. While most low-grade injuries can be managed conservatively, severe injuries often necessitate surgical intervention. The study highlights the importance of early intervention, proper follow-up, and monitoring for complications to improve patient outcomes.