Renal trauma

Medical history—low K BP with pregnancy birth control pills (BCP) licorice over the counter (OTC) phrine renal trauma episodes of HTN inferring pheochromocytoma, that is, headache hyperhidrosis high heart rate hypermetabolism, etc. 

Dinkel HP, Danuser H, Triller J (2002) Blunt renal trauma minimally invasive management with microcatheter embolization experience in nine patients. Radiology 223 723-730... 

Santucci RA, Wessells H et al. (2004) Evaluation and management of renal injuries consensus statement of the renal trauma subcommittee. BJU Int 93 937-954 American College of Surgeons (1997) Advanced trauma life support manual, 6th edn. ACS, Chicago Kaur S, Heard SO (1996) Airway management and endotracheal intubation. In Rippe JM, Irwin RS, Fink MP, Cera FB (eds) Intensive care medicine, vol 1. Little Brown, New York, pp 1-15... 

Table 4.3. Organ Injury Score for Blunt Renal Trauma ...

Carroll PR, Klosterman PW.McAninch JW (1988) Surgical management of renal trauma analysis of risk factors, technique and outcome. J Trauma 28 1071-1077... 

Thompson IM, Latourette H, Montie JE et al. (1977) Results of non-operative management of blunt renal trauma. J Urol 118 522-524... 

McGopnigal MD, Lucas CE, Ledgerwood AM (1987) The effects of treatment of renal trauma on renal function. J... 

Kristjansson A, Pedersen J (1993) Management of blunt renal trauma. Br J Urol 72 692-696... 

Larsen DW, Pentecost MJ (1992) Embolotherapy in renal trauma. Semin Intervent Radiol 9 13-18... 

Evaluating a child vdio has sustained abdominal injury is daily practice in a department of pediatric radiology. In this chapter, emphasis will be put on pediatric particularities of renal injuries. Obviously, renal trauma cannot be separated from associated traumatic lesions. This is especially true in organizing the imaging strategy. 

Nuclear medicine studies can be performed in the late stage of renal trauma to evaluate the residual renal function. Either DMSA- Tc or MAG3- " Tc studies can be performed. MAG3- Tc is preferred in patients in whom excretion should be assessed as well. Functional MR urography is a promising examination in that field (Fig. 25.12). 

Marcos HB, Noone TC, Semelka RC (1998) MRI evaluation of acute renal trauma. J Magn Reson 8 989-990... 

Mayor B, Gudinchet F, Wicky S, Reinberg O, Schnyder P (1995) Imaging evaluation of blunt renal trauma in children diagnostic accuracy of intravenous pyelography and ultrasonography. Pediatr Radiol 25 214-218... 

The nitrates are used cautiously in patients witii severe hepatic or renal disease, severe head trauma, acute myocardial infarction (MI), hypotiiyroidism, and during pregnancy (Pregnancy Category C, except for amyl nitrate) or lactation. 

The uses of the various anabolic steroids include management of anemia of renal insufficiency, control of metastatic breast cancer in women, and promotion of weight gain in those with weight loss after surgery, trauma, or infections. Stanozolol is used prophylactically... 

All patients with major patterns are monitored for rhabdomyolysis and renal failure. An early sign of rhabdomyolysis is an elevated serum uric acid, associated with an increase in serum CK. Within 8 to 12 hours, the serum tests are repeated. If the uric acid falls and the CK rises, rhabdomyolysis is likely. Renal function tests may also be increased at this time. When the diagnosis of rhabdomyolysis is made, the patient is treated with 40 mg furose-mide IV once, and IV fluids. Urine myoglobin concentrations are obtained. If the patient develops renal failure, hemodialysis or peritoneal dialysis may be necessary. In all cases, multiple drug intoxication, trauma, and rhabdomyolysis are ruled out or treated. All patients are kept under observation until they are asymptomatic. 

Modified amino acid solutions are designed for patients with altered protein requirements associated with hepatic encephalopathy, renal failure, and metabolic stress or trauma. However, these solutions are expensive and their role in disease-specific PN regimens is controversial. 

Risk factors for ARF include advanced age, acute infection, preexisting chronic respiratory or cardiovascular disease, dehydration, and chronic kidney disease (CKD). Decreased renal perfusion secondary to abdominal or coronary bypass surgery, acute blood loss in trauma, and uric acid nephropathy also increase risk. 

Respiratory, hematological, liver, and renal effects were not observed in 11 hexachloroethane-exposed workers. The identification of hexachloroethane in the plasma of these workers confirmed exposure, although the workers were wearing protective equipment. Mild dermal irritation was noted that may have been from exposure or a result of a local trauma effect of the protective equipment. 

Dopamine exhibits its primary action of the cardiovascular system, kidneys, and mesentery. It is used as a temporary agent for treating hypotension and circulatory shock caused by myocardial stroke, trauma, kidney rejection, and endogenous septicemia. The main indication for use of this drag is shock of various origins (cardiogenic, postoperational, infectious-toxic, anaphylactic), severe hypotension, and imminent renal insufficiency. Synonyms of dopamine are dopamin and inotropin. 

Imipenem-cilastatin is one of the drugs of first choice for the empirical therapy of many polymicrobial pulmonary, intraabdominal, and soft tissue infections. The notable adverse effect of imipenem-cilastatin is seizures affecting 1% of patients. Risk factors for seizures are old age, head trauma, previous seizure disorder, cerebrovascular accident, and renal failure. Among patients with a history of penicillin allergy, 10% are cross-sensitive to imipenem-cilastatin. 

Treatment and prevention of acute hypotension shock (associated with cardiac decompensation, Ml, open heart surgery, renal failure, or trauma), treatment of low cardiac output, treatment of CHF IV 1 mcg/kg/min up to 50 mcg/kg/min titrated to desired response. 

Contraindications Diabetic complications, such as ketosis, acidosis, and diabetic coma monotherapy for type 1 diabetes mellitus severe hepatic or renal impairment stress situations, including severe infection, trauma, and surgery... 

It is indicated in shock syndrome due to Ml, trauma, septicaemia, heart surgery, renal failure and chronic cardiac failure. 

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