WOFAPS 2025 8th World Congress of Pediatric Surgery

Mehmet Sarıkaya ¹, Fatma Özcan Sıkı ¹, Gamze Kaygısız Bayındır ¹, Metin Gündüz ¹, Tamer Sekmenli ¹, Alaaddin Nayman ², İlhan Çiftçi ¹

¹ Selcuk University Faculty of Medicine, Department of Pediatric Surgery
² Selcuk University Faculty of Medicine Department of Radiology

Introduction:

Renal artery occlusion after blunt trauma is a very rare condition.We report 3 cases of renal artery occlusion after trauma at the ages of six, fourteen and seventeen.

Case1:A six-year old patient was brought to the emergency department due to a fall from a height of approximately 10 meters.Computed tomography (CT) showed no contrast passage in the right renal artery.Traumatic renal artery occlusion was considered.The patient was taken to intensive care unit.Control CT angiography was performed at the 12th hour of follow-up.On the images, it was observed that both renal arteries were patent and the right kidney was contrasted.The patient was discharged on the seventh day after trauma with bed rest.No pathology was observed on urinary system Doppler ultrasonography performed in the late follow-up of the patient.

Case2:A 14-year-old patient was brought to the emergency department with a fall of approximately 12 meters.CT scan showed no blood supply in the right renal artery and grade 4 laceration in the left kidney.Thrombolytics were administered to the right renal artery by interventional radiology.Doppler ultrasonography of the urinary system performed before discharge showed normal flow in the right renal artery.Scintigraphy performed 3 months after discharge showed a right renal function of 36% and left renal function of 64%.

Case3:A seventeen-year-old male patient was evaluated with renal angiography after a motorcycle accident and abdominal tomography showed no blood supply in the right renal artery.Renal angiography was performed at the 48th hour of follow-up because hypertension persisted.Renal artery occlusion persisted.The patient's treatment was adjusted and he was discharged on the 10th day.Scintigraphy performed at the third month after the trauma showed right renal function 24% and left renal function 76%.

Discussion: While spontaneous regression of renal artery occlusion was observed in all of our patients, the decreased function of the damaged side on scintigraphy was thought to be due to parenchymal damage secondary to micro emboli.In cases of bilateral renal artery occlusion, prompt revascularization with endovascular interventions is recommended, otherwise surgical intervention is recommended, whereas in unilateral cases, revascularization with endovascular interventions or conservative treatment is recommended.