genitourinary trauma. kidney mechanisms of injury 1.blunt renal trauma accidents, falls, crush...
TRANSCRIPT
kidney
Mechanisms of Injury
1.Blunt renal trauma
accidents, falls, crush
2.Penetrating trauma
gunshot, stab
kidney
Classification of Injury1.Simple laceration2.Subcapsular hematoma 3.Renal contusion 4.Renal rupture5.Laceration of renal artery and vein6.Perirenal hematoma 7.Laceration through collecting system
kidney
Diagnosis 4.Urinalysis gross hematuria,microscopic hematuria The degree of hematuria may not predict the
severity of renal injury.
5.X-ray examination KUB Intravenous pyelogram (IVU) Arteriography
kidney
Treatment
1.Observation
Blood pressure,pulse,breathe,urine,
hemachrome
keep the bed 3-4 weeks
kidney
Treatment
2. Renal exploration
Indication:
Uncontrolled bleeding
Renovascular injury
Nonviable parenchyma
Major urinary extravasation
Ureter
Treatment
1. One-stage repair during the initial
evaluation of a trauma
2. External drainage for 3 months if injury
above 24h.
Bladder Classification and Mechanism of Injury
1.Causes
Blunt trauma, penetrating trauma
Endoscopy
2.Site
Extraperitoneal Rupture
Intrapritoneal Rupture
Combined Rupture
Bladder
Treatment
1. Intrapritoneal Rupture
Surgical exploration and repair
2. Extraperitoneal Rupture
Surgical exploration and repair or
Catheterization
3. Anti-infection
Urethra
Site
1. Posterior urethra
prostatic and membranous injuries above
or including the urogenital diaphragm
2. Anterior urethra
injuries of the bulbous and penile urethra
Urethra
Pathology
1. Sprian
2. Cracking
3. Rupture
Stage:
1. Trauma period
2. Inflammation period
3. Structure period
Urethra
Presentation
1. Shock
2. Bleeding
3. Pain
4. Void unsuccessful and Rentention
5. Haematoma
6. Urine leak
Urethra
Diagnosis
1. History
2. Physical examination
digital rectal examination
3. Catheter insert
4. Retrograde urethrography
Urethra
Treatment
1. Anti-infection and prevent shock
2. Main urethral successive
3. Drainage urine of bladder
4. Drainage urine leak