The clinical analysis of 11 Patients with traumatic renal subcapsular hematoma / 中国综合临床

ABSTRACT

Objective To investigate the cause and treatment experience for traumatic renal subcapsular hematoma.MethodsThe data of eleven cases with traumatic renal subcapsular hematoma were reviewed.four cases were caused by external injury,and seven cases were iatrogenic,including four cases of postESWL patients,two cases of post-ureteroscopic lithotripsy patients and one case after percutaneous renal biopsy.The patients were treated with conservative treatment,percutaneous drainage of the hematoma and surgical exploration,respectively.Results Four cases received conservative treatment,six cases received percutaneous drainage of the hematoma,and one case received surgical exploration.Seven of the ten cases who received conservative treatment or percutaneous drainage of the hematoma were continuously followed up for 1 to 3 years.They recovered well without complications such as renal hypertension,renal function impairment,hydronephrosis and renocortical pyogenic infection.One case was performed nephrectomy due to severe trauma and hemorrhage during the surgical exploration.ConclusionTraumatic renal subcapsular hematoma usually occurs after flank abdomen injury,iatrogenic injury such as ESWL,ureteroscopic lithotripsy and percutaneous renal biopsy.CT and ultrasound examination are the major means to diagnose traumatic renal subcapsular hematoma and determine the severity.Optimistic prognosis can be obtained after conservative treatment and percutaneous drainage of the hematoma.Surgical exploration should be avoided as far as possible.