How dangerous is a blow to the kidneys: what treatment to take

A blow to the kidneys can cause the slightest damage to them - this is a bruise that manifests itself in a situation where a blow was delivered to the lumbar region, a person fell on his feet or on his back, when, upon landing, there is a short-term increase in intra-abdominal pressure due to overstrain of the abdominal muscles .

After receiving a bruise, the patient, as a rule, complains of pain in the lumbar region, and the general state of health does not worsen in any way. An admixture of blood in the urine may be detected.

It is important!

In order to determine the severity of the injury, the patient is examined by a doctor. Such pathologies most often do not require surgical intervention.

Damage mechanism

The mechanism of injury to the kidney may be different. It depends on the direction of the blow and on its strength, on the anatomical localization of the organ, on its topographic relationship with the 11th and 12th ribs, with the spine. Also, the severity of damage is affected by the physical characteristics of the kidney, human musculature, the presence of subcutaneous fat, the degree of intestinal filling, and intra-abdominal pressure indicators.

With a direct injury to the kidney, namely with a bruise in the lumbar region, a fall on a hard surface, strong compression, or with an indirect lesion - a fall from a great height, body bruises or jumping, a kidney rupture may occur. The simultaneous influence of several traumatic factors at once can provoke squeezing of the organ between the ribs or transverse processes of the vertebrae in the lumbar region, and an increase in fluid pressure in the kidney.

If pathological changes were already diagnosed in the kidney before the injury, then the organ can be injured even with mild blows. In this case, a spontaneous rupture of the kidney occurs due to trauma to the lumbar region or abdomen.

What happens after a kidney injury

With severe bruising of the urinary organs, the consequences of a blow to the kidneys can be quite severe. Most often, the following symptoms appear: pronounced pain, bleeding, frequent urge to urinate, excretion of urine into nearby organs, disruption of nearby organs. These symptoms can cause early or late complications.

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Clinical signs of kidney injury are varied and correlate with the type and severity of the bruise. First of all, after injury, a triad of symptoms is manifested - this is swelling in the lumbar region, pain in this area and the release of blood along with urine.

The kidney hurts after a blow in 95% of cases with isolated damage, and patients always complain of pain with combined injury. Pain develops due to damage to organs and tissues near the kidney, due to stretching of the fibrous capsule, ischemia of the renal parenchyma, strong pressure on the peritoneal area with an increasing hematoma, due to blood clots due to the urinary canals.

By nature, the pain can be acute, dull, give to the groin area. Nausea with vomiting, irritation of the abdominal wall, bloating, and an increase in body temperature are often the main causes of errors in the diagnosis.

Swelling in the lumbar region or in the area under the ribs occurs due to the formation of a hematoma or accumulation of blood and urine near the kidney or in the tissue behind the peritoneum. Swelling is detected in 10% of cases. At the same time, some experts note the presence of a tumor in the lumbar region in 43%. Large hematomas or extensive areas of accumulation of blood and urine can be located from the diaphragm to the pelvic region, and after two to three weeks they can even appear on the scrotum or on the thighs.

The most significant and indicative symptom of kidney injury is the detection of blood in the urine.

In addition to the listed signs, when a kidney is injured, atypical symptoms may appear that play an important role in making a diagnosis - these are:

• dysuria, which can reach complete urinary retention due to blockage of the bladder with blood clots;
• pain in the lower abdomen;
• signs of irritation of the abdominal wall;
• disruption of the gastrointestinal tract;
• symptoms of internal hemorrhage;
• fever due to the occurrence of pyelonephritis or suppuration caused by trauma.

The severity of clinical symptoms in a closed kidney lesion makes it possible to classify the contusion into three degrees of severity - this is important for the development of an appropriate treatment.

How is kidney injury diagnosed and treated?

The doctor establishes the fact of damage to the kidney, based on the patient's complaints, the study of the anamnesis, the presence of clinical symptoms. But identifying the type and nature of the lesion can often cause some difficulties and a detailed urological examination will be required for its implementation. For each specific case, diagnostic methods are selected individually, depending on the indications.

Most experts believe that the treatment of stroke to the kidneys in 87% of all cases should be carried out by conservative methods.

With an isolated closed mild or moderate kidney injury with stable hemodynamic parameters and in the absence of indications for surgical intervention, the doctor decides to limit himself to conservative treatment and dynamic observation of the victim.

It is important!

With a slight injury to the organ, treatment may consist only in conducting constant monitoring of the patient.

Conservative therapy of isolated injuries is carried out under the condition that the general condition of the patient is satisfactory, there is no profuse hematuria, there are no signs of internal bleeding, signs of increased hematoma and signs of urinary infiltration.

Conservative treatment involves adherence to strict bed rest for ten to fifteen days, monitoring of hematocrit and hemodynamics, prophylactic use of antibiotics, painkillers, hemostatic and preventing the formation of rough scars of medicines.

The described treatment is carried out until the cessation of blood excretion along with urine, and if carried out correctly, it succeeds in 98% of cases of kidney damage.

Constant monitoring of the patient by a doctor makes it possible to control the treatment process and, if necessary, urgently organize an open surgical intervention, because there may be a risk of a two-phase rupture of the kidney.

Absolute indications for the implementation of a surgical operation are: a pulsating and growing hematoma and unstable hemodynamic parameters.