Background: Abdominal trauma whether blunt or penetrating is a harbinger of the possibility of genitourinary injuries. The kidney is an organ frequently injured when there is a genitourinary injury. The menace of armed banditry has led to the increased presentation of life-threatening organ system injuries to our facilities such as a shattered kidney. The associated mortality can be significant even where there is a functioning trauma system.
Objectives: The aim of this study was to investigate a patient who survived shattered kidney injury despite non-existent functioning trauma system.
Case report: A 75-year-old farmer presented with a 4 h history of gunshot injury to the right flank and left cheek associated with bleeding, haematuria, and shock was investigated. His admitting packed cell volume was 16.4%. The serum chemistry was within normal range and no features of peritonitis was observed. He had resuscitation according to the principle of the Advanced Trauma Life Support protocol and emergency exploratory laparotomy with right simple nephrectomy.
Conclusion: The management of shattered kidneys involves prompt and simultaneous resuscitation using the Advanced Trauma Life Support (ATLS) protocol including emergency exploratory laparotomy and simple nephrectomy to guarantee patient survival.