Kidney blow: consequences and mechanism of injury, organization of treatment

Kidney damage can cause the slightest damage to the kidneys - this is a bruise that manifests itself in a situation where a stroke was applied to the lumbar region, there was a fall of a person on his legs or on his back, when a short-term increase in intraperitoneal pressure occurs during landing due to muscle overstrainpress.

After receiving a bruise, the patient, as a rule, complains of pain in the lumbar region, and overall health does not deteriorate. An admixture of blood in the urine can be detected.

This is important!

In order to determine the severity of the injury, the patient is examined by a doctor. Such pathologies most often do not require an operative intervention.

Mechanism of damage

The mechanism of injury to the kidney can be different. It depends on the direction of the impact and on its strength, on the anatomical localization of the organ, on its topographic correlation with the 11th and 12th ribs, with the vertebrae. Also, the severity of the damage is affected by the physical characteristics of the kidney, the musculature of a person, the presence of a subcutaneous fat layer, the degree of filling of the intestine, and the indices of intra-abdominal pressure.

In case of direct injury to the kidney, namely, when the lumbar region is bruised, falling on a hard surface, strong squeezing, or with indirect damage - falling from a high altitude, bruises of the body or jumping, a kidney rupture may occur. Simultaneous influence of several traumatic factors can provoke the squeezing of the organ between the ribs or transverse processes of the vertebrae in the lumbar region, an increase in the pressure of the fluid in the kidney.

If the pathological changes have already been diagnosed in the kidney before the injury has been received, the organ may be injured even with mild strokes. At the same time, a spontaneous rupture of the kidney occurs due to a trauma in the lumbar region or abdomen.

What happens after a bruise of the kidneys

With a severe bruising of the urinary organs, the consequences of a stroke on the kidneys can be quite heavy. The most common symptoms are: severe pain, bleeding, frequent urge to urinate, urination in nearby organs, disruption of the work of nearby organs. These symptoms can trigger the onset of early or late complications.

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Clinical signs of kidney trauma are diverse and correlate with the variety and severity of the injury received. First of all, after the trauma, there is a triad of symptoms - a lump in the lower back, pain in this area and blood separation along with the urine.

The kidney is aching after a stroke in 95% of cases with isolated damage and always patients complain of pain in case of combined trauma. The pain develops due to damage to organs and tissues near the kidney, due to the expansion of the fibrous capsule, ischemia of the renal parenchyma, severe pressure on the peritoneal area with increasing hematoma, due to obstruction of the urinary canals by blood clots.

By nature, the pain can be acute, blunt, giving into the groin area. Often accompanying kidney trauma, nausea with vomiting, irritation of the abdominal wall, bloating, increase in body temperature become the main causes of errors in the diagnosis.

Swelling in the lumbar region or in the area under the ribs occurs due to the formation of a hematoma or blood and urine accumulation near the kidney or in the fiber behind the peritoneum. Tumescence is detected in 10% of cases. At the same time, some experts note the presence of a tumor in the lumbar region in 43%.Large bruises or large areas of blood and urine accumulation can be located from the diaphragm and up to the pelvic area, and in two to three weeks they can appear even on the scrotum or on the hips.

The most significant and indicative symptom of a kidney injury is the detection of blood in the urine.

In addition to these symptoms, atypical injuries can occur atypical symptoms that play an important role in diagnosing is:

• dysuria, which can reach the full delay of urination due to clotting of the bladder with blood clots;
• pain in the lower abdomen;
• signs of irritation of the abdominal wall;
• disruption of the gastrointestinal tract;
• symptoms of internal hemorrhage;
• febrile condition due to the occurrence of pyelonephritis or suppuration caused by trauma.

The severity of clinical symptoms with closed kidney damage makes it possible to classify the injury into three degrees of severity - this is important for developing the appropriate treatment.

How is diagnosis and treatment of kidney injury

The doctor determines the fact of damage to the kidney, based on the patient's complaints, the history of the study, the presence of clinical symptoms. But identifying the variety and nature of the lesion can often cause some difficulties and for its implementation a detailed urological examination will be required. For each specific case, the individual diagnostic methods are selected depending on the indications.

Most experts believe that treatment of a kidney shock in 87% of all cases should be carried out conservatively.

With an isolated closed, mild or moderate severity of kidney trauma with stable hemodynamic parameters, and provided there is no indication for surgery, the physician decides to restrict conservative treatment and dynamic observation of the affected person.

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In case of minor trauma of the body, treatment can consist only in the constant monitoring of the patient.

Conservative therapy of isolated injuries is performed provided that the general condition of the patient is satisfactory, there is no abundant hematuria, no signs of internal bleeding, signs of an increase in the hematoma and signs of urinary infiltration.

Conservative treatment requires strict bed rest for ten to fifteen days, monitoring of hematocrit and hemodynamics, prophylactic use of antibiotic drugs, analgesic, blood-restoring and preventing the formation of rough scars of medicines.

The treatment described is performed until the release of blood with urine ceases, and if done correctly, it ends in 98% of kidney damage cases.

Continuous monitoring of the patient's physician makes it possible to keep the treatment under control and, if necessary, to urgently organize open surgery, because there may be a risk of a two-phase rupture of the kidney.

Absolute indications for the implementation of a surgical operation are: a pulsating and increasing in the size of the hematoma and unstable parameters of hemodynamics.

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