Treatment of pediatric kidney injuries

Injuries to the kidneys, bladder, ureter or urethra are closed lesions of the urinary system. Of these, children with kidney injuries accounted for the highest proportion with 60-90% of cases of non-surgical kidney damage.

The kidneys are parts of the abdomen, located behind theitone and covered with rib arches, the back of which is covered with dorsal muscles, spine. Kidney injury occurs when a force acts from the outside, this external force is in the opposite direction to the internal force of the torso (the flow of blood and urine through the kidneys).

• Manifestations of kidney injury in children:

The child will have manifestations such as: Lumbar pain, the level of pain will gradually increase after the injury; Manifestations of abdominal obstruction, nausea; Bloody urination (urine of a pink or deep red color). If an infection occurs, fever, painin the lower ribs will occur. The internal hematoma strains the lumbar flank. In case of severe injury, it will combine coordinated lesions such as fractures, bladder ruptures, skin tears. After the event of an injury if the child manifests shock, dizziness, blue skin, pale mucous membranes, sweating, rapid pulse, blood pressure drops, this is the most severe level of injury.

• Classification of levels of kidney injury in children:
  • Level 1: Kidney crushing (damage to the shallow hematoma of the lower shell of the kidney);
  • Level 2: Mild renal stamping (damage to the shell area that has not reached the renal marrow area);
  • Level 3: Severe renal stamping (damage to the shell area spreads to the renal marrow area, accompanied by tearing of the renal tank);
  • 4th degree: Rupture of the kidneys (kidneys break into 2 or more pieces);
  • Level 5: Damage to the kidney stalk.

Boys are more hyperactive than girls, so the proportion of boys with kidney injuries is higher than in girls. In addition to the cause of injury caused by accidents, external motivation, kidney injury in children can also be related to congenital kidney conditions such as water kidneys,horseshoe kidneys,… In fact, the cause of kidney injury comes from higher levels of kidney injury in children, the extent of which is even more severe than kidney injury in adults.

The mechanism of injury caused by external impact on a child's kidneys can come from an object that is a prison object or a sharp object. Injuries caused by imprisonment are injuries caused by traffic accidents, falls from above, accidents in daily life, sports. The cause comes from traffic accidents accounting for a high proportion. The rate of damage, tearing of renal or renal blood vessels accounts for about 10-15% of injuries caused by prison. Closed abdominal injuries according to damaged blood vessels accounted for a low rate of only 0.1%.

Gunshot wounds, stabbing knives are injuries caused by sharp objects. This injury causes very severe and unpredictable injuries compared to prison-inmate kidney injuries. Gunshot wounds can destroy the owner of kidney tissue, spreading to other bodies in the direction of the bullet's movement. Most renal cuts are required if a gunshot wound is caused by a gunshot wound.

• Principles of treatment:

First it is necessary to hetolys the patient, preserve the kidneys after the injury, let the patient lie unconscious at the bed, put a catheter from the urethra – bladder to monitor the state of hematuria. Conduct cold compresses of the kidneys, infusions, additional blood transfusions if necessary. During treatment the doctor will combine antibiotics, analgesic, hematoma or diure diureges for the patient. In case of severe injury, the doctor may prescribe surgery. In case of serious injury combined with coordinated lesions, it is necessary to treat even the accompanying lesions.

• Treatment of mild kidney injury:

Patients with kidney damage who appear hematoma should be admitted to the hospital for treatment to preserve the kidneys until the urine is in a normal state. In case of normal micro-hematoma and UIV, the patient can be treated at home.

• Treatment of severe kidney injury:

Depending on the degree of kidney damage and CT scan results,if the patient is stable, he/she can be treated conservatively with blood transfusions, infusions, broad-spectrum antibiotics and proper nutrition and rest. If the results of repeated CT scans show that the progress of the disease does not improve, the signs of bleeding are still progressing, the doctor will conduct a consultation and prescribe a surgical examination.

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