Hospital Practices and Research

Shattered Kidney: A Fallout of Armed Banditry Managed at Usmanu Danfodiyo University Teaching Hospital

Document Type : Case Report

Authors

Abdullahi Khalid 1
Ibrahim Umar Abubakar 2
Ahmed Mohammed Umar 1
Abubakar Sadiq Muhammad 1
Ngwobia Peter Agwu 1
Abdullah Abdulwahab-Ahmed 1

1 Tetfund Centre of Excellence in Urology and Nephrology, Institute of Urology and Nephrology, Usmanu Danfodiyo University and Teaching Hospital Sokoto, Nigeria

2 General Surgery Unit, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

https://doi.org/10.30491/hpr.2023.402567.1395
Abstract
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.

Keywords

Abdominal Injuries
Kidney
Trauma
Advanced Trauma Life Support Care
Nephrectomy
  1. Govindarajan KK, Utagi M, Naredi BK, Jindal B, Sambandan K, Subramaniam D. High grade renal trauma due to blunt injury in children: do all require intervention?. J Bras Nefrol. 2019;41:172-5. doi:10.1590/2175-8239-JBN-2018-0186
  2. Moore EE, Shackford SR, Pachter HL, McAninch JW, Browner BD, Champion HR, et al. Organ injury scaling: spleen, liver, and kidney. J Trauma Acute Care Surg. 1989; 29(12):1664-6.
  3. Salimi J, Nikoubakht M, Zareei MR. Epidemiologic study of 284 patients with urogenital trauma in three trauma centers in Tehran. Urol J. 2004;2:47-50.
  4. Erlich T, Kitrey ND. Renal trauma: the current best practice. Ther Adv Urol. 2018;10(10):295-303. doi:10.1177/1756 287218785828
  5. Okereke IC, Zahoor U, Ramadan O. Trauma care in Nigeria: time for an integrated trauma system. Cureus. 2022;14(1):e20880. doi:10.7759/cureus.20880
  6. Olaniyan A, Yahaya A. Cows, bandits, and violent conflicts: Understanding cattle rustling in Northern Nigeria. Afr Spectr. 2016;51(3):93-105. doi:10.1177/000203971605100305
  7. Abdullahi A. Rural banditry, regional security and integration in West Africa. J Soc Political Sci. 2019;2(3):644-54. doi:10.31014/aior.1991.02.03.107
  8. Voelzke BB, Leddy L. The epidemiology of renal trauma. Transl Androl Urol. 2014;3:143-9.
  9. da Costa IA, Amend B, Stenzl A, Bedke J. Contemporary management of acute kidney trauma. J Acute Dis. 2016;5(1):29-36. doi:10.1016/j.joad.2015.08.003
  10. Halis F, Amasyali AS, Yucak A, Yildiz T, Gokce A. Intrathoracic Kidney after Blunt Abdominal Trauma: A Case Report and Review of the Literature. Case Rep Urol. 2015;2015:682649. doi:10.1155/2015/682649
  11. Wendler JJ, Jürgens J, Schostak M, Liehr UB. Traumatically shattered kidney without urine extravasation or vascular amputation. Case Rep. 2015;2015:bcr2014208303. doi:1 136/bcr-2014-208303
  12. Tait CD, Somani BK. Renal trauma: case reports and overview. Case Rep Urol. 2012;2012:207872. doi:10.11 55/2012/207872
  13. Ofoha CG, Shuaibu SI, Onowa VE, Galam ZZ. Contemporary management of genitourinary injuries in a tertiary trauma center in Nigeria. Int J Res Med Sci. 2018;6:1134-8. doi:10.18203/2320-6012.ijrms20181268
  14. Sarvestani AS, Zamiri M. Assessment of genitourinary trauma in Southeastern Iran. Trauma Mon. 2013;18(3):113-6. doi:5812/traumamon.11694
  15. Barman MK, Maitra T, Biswas A, Mukherjee K, Venugopal PN. Epidemiology and Management of Urogenital Trauma: The 7-Years’ Experience at West Bengal, India. Inter J Public Health. 2014;1(2):66-9.
  16. Salako AA, Adisa AO, Eziyi AK, Banjo OO, Badmus TA. Traumatic urologic injuries in ile-ife, nigeria. J Emerg Trauma Shock. 2010;3(4):311-3. doi:4103/0974-2700.70742
  17. Coccolini F, Moore EE, Kluger Y, Biffl W, Leppaniemi A, Matsumura Y, et al. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 2019;14:54. doi:10.11 86/s13017-019-0274-x
  18. Kavakli HŞ, Delice O. Isolated Renal Injury After Blunt Trauma: Case Report. J Emerg Med Case Rep. 2010;1(1): 18-20.
  19. Spain DA, Berger Y, Boyarsky AH, Flancbaum LJ. Nonoperative management of bilateral shattered kidneys from blunt trauma. Urology. 1993;41(6):579-81. doi:10.10 16/0090-4295(93)90110-V
  20. Fang C, Husainy MA, Huang D. A shattered kidney: a pitfall in imaging of renal trauma. Case Rep. 2015;2015: bcr2015211496. doi:10.1136/bcr-2015-211496
  21. Xie J, Liu Y, Chen T, Xiao KF. Case report of bilateral penetrating renal trauma caused by a wooden stick. Medicine. 2020;99(16):e19853. doi:10.1097/MD.0000000000019853
Hospital Practices and Research
Volume 8, Issue 2 - Serial Number 30
Spring 2023
Pages 280-283

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