CASE REPORT: NON OPERATIVE MANAGEMENT OF A 40-YEAR-OLD WOMAN WITH GRADE IV RENAL TRAUMA AND ACUTE KIDNEY FAILURE POST EXPLORATIONAL LAPAROTOMI IN GRADE IV HEPAR LACERATION

Abstract

In cases of abdominal injuries, one of the crucial organs is the kidney. The mechanism of renal trauma is induced by blunt and sharp trauma. Blunt trauma and renal trauma might occur in 63% of car accidents. According to the American Association for the Surgery of Trauma (AAST), management of renal trauma includes of conservative, minimally invasive techniques, and surgery, depending on the symptoms and degree of renal trauma. Priority management of grade IV-V renal trauma cases that are hemodynamically stable and can be managed non-operatively/conservatively. The purpose of this case report is to provide a case of abdominal trauma in a 40-year-old female patient suffering from hemodynamic instability as a result of a car accident. The patient reported stomach and chest pain, but no hematuria or hypotension. The patient suffered from intra-abdominal hemorrhage and required five bags of whole blood transfusions. AAST grade IV renal laceration and grade IV liver laceration were discovered during an abdominal CT scan. Non-operative treatment of renal trauma was used, whereas exploratory perihepatic packing laparotomy was used to treat hepatic lacerations. After an exploratory laparotomy, the patient had hemodynamic instability, which was accompanied by acute kidney failure consequences. Blunt trauma is a common cause of kidney trauma. Non-operative/conservative care of grade IV-V renal trauma with stable hemodynamics is the priority. If there are absolute and relative indications, minimally invasive techniques and surgery can be undertaken.