EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

European Journal of Pharmaceutical and Medical Research (EJPMR) has indexed with various reputed international bodies like : Google Scholar , Indian Science Publications , InfoBase Index (In Process) , SOCOLAR, China , Research Bible, Fuchu, Tokyo. JAPAN , International Society for Research activity (ISRA) , Scientific Indexing Services (SIS) , Polish Scholarly Bibliography , Global Impact Factor (GIF) (Under Process) , Universal Impact Factor , International Scientific Indexing (ISI), UAE  , Index Copernicus , CAS (A Division of American Chemical Society) USA (Under Process) , Directory of Open Access Journal (DOAJ, Sweden, in process) , UDLedge Science Citation Index , CiteFactor , Directory Of Research Journal Indexing (DRJI) , Indian citation Index (ICI) , Journal Index (JI, Under Process) , Directory of abstract indexing for Journals (DAIJ) , Open Access Journals (Under Process) , Impact Factor Services For International Journals (IFSIJ) , Cosmos Impact Factor , Jour Informatics (Under Process) , Eurasian Scientific Journal Index (ESJI) , International Innovative Journal Impact Factor (IIJIF) , Science Library Index, Dubai, United Arab Emirates , Pubmed Database [NLM ID: 101669306] (Under Process) , 

 ISSN 2394-3211

Impact Factor: 4.897

 ICV - 79.57

Abstract

DO WE NEED TO OPERATE IN POST-TRAUMATIC RENAL TRANSECTION WITH BLEEDING? PATIENT COMES TO HER OWN AID IN SOLVING THE DILEMMA – A CASE REPORT

Deepak David*, Vasudevan Thirugnanasambandam, Kalyanaram Kone, Joseph Philipraj, Brahadeeswaran Subbaiyan and Mossadeq Abdulrazak

ABSTRACT

High-grade renal injury occurs predominantly in pediatric population when compared to adults. Non-operative management is advocated in stable patients irrespective of the grade of injury and intervention is recommended in unstable patients. Children presenting with active bleeding are a source of treatment dilemma because of the limited amount of circulating blood volume and the ease with which they can go in to shock with a small amount of blood loss. Here, we report a 9-year-old girl who on evaluation following blunt trauma was found to have complete transection of the upper pole of right kidney with large perinephric hematoma. She was initially managed conservatively, but the plan changed to intervention on the 2nd day because of significant hemoglobin drop and hypotension. Renal Angiography was done before surgical procedure to see for the feasibility of minimal intervention procedure. It revealed active bleeding from an accessory upper polar renal artery, and we then proceeded with selective embolization of the accessory upper polar artery. Patients own vascular anomaly helped us solving the dilemma as embolization could be done without significant risk of migration. Following embolization, the bleeding stopped and she had an uneventful recovery. This case highlights the need of using minimal intervention procedures before resorting to surgery in post-traumatic renal injuries and treating these patients in tertiary care centres where all the facilities are available.

Keywords: High grade renal injury, complete transection of upper pole, renal angiography, selective angioembolization of accessory upper polar artery.


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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process)