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Management of renal trauma in children: a 13-Year retrospective study in a tunisian pediatric surgery department
Syrine Laribi 1, Myriam Ben Fredj 1, Samia Belhssan 1, Sabrine Ben Youssef 1, Sawsen Chakroun 2, Maha Ben Mansour 2, Amine Ksia 1, Mongi Mekki 1, Mohsen Belghith 1, Lassaad Sahnoun 1
1 Pediatric surgery department, Fattouma Bourguiba Hospital.
2 Pediatric anaesthesia and intensive care department, Fattouma Bourguiba Hospital.
Purpose: Renal trauma in children, although relatively rare, is a significant component of pediatric abdominal injuries and can pose a life-threatening emergency. Due to anatomical and physiological differences, children are more vulnerable to renal injuries than adults.This study describes the epidemiological, clinical, radiological, and therapeutic features of renal trauma in children and evaluates the outcomes of management strategies employed in a pediatric surgical department in Tunisia.
Methods: This was a retrospective, descriptive study conducted at the Pediatric Surgery Department of Fattouma Bourguiba University Hospital in Monastir over a 13-year period (2010–2022). It included all patients under 14 years of age who sustained renal trauma confirmed by imaging. Data were collected from medical records and analyzed using SPSS software.
Results: Twenty-seven cases of renal trauma were identified, accounting for 17.8% of pediatric abdominal traumas. The median age was 7 years with a male predominance (sex ratio 4.4). Most traumas were closed (96.3%) and often associated with polytrauma (77.8%), mainly from domestic accidents (55.5%) and road traffic accidents (40.7%). CT imaging was the diagnostic gold standard. Non-operative management (NOM) was applied in all cases, even in high-grade and penetrating injuries. Conservative treatment included bed rest, analgesia, and clinical-radiological monitoring. Only a few patients required interventional procedures such as drainage or stenting. No patients required emergency nephrectomy. The outcomes were generally favorable, with a low complication rate and no mortality.
Conclusion: Non-operative management is safe and effective for pediatric renal trauma, including high-grade injuries. A structured management protocol, based on hemodynamic stability and radiologic findings, allows for organ preservation and favorable long-term outcomes. Local experience supports the adoption of NOM as the standard approach in children.