Early surgery in the management of pediatric blunt renal trauma.

Of 40 children with major blunt renal injuries managed surgically 30 (75 per cent) could be followed up to 13 years postoperatively (mean 4.5 years). Measurements of renal size on sequential excretory urograms demonstrated normal growth of the traumatized kidney in all but 1 child. No hypertrophy of the contralateral kidney was noted in any child. Kidney length correlated with renal plasma flow calculated by sequential scintiscans (r equals 0.77). Hypertension was noted in 3 patients. Split renal vein renin studies and angiography showed that hypertension was caused by renal artery stenosis in 1 patient. Although we cannot draw any firm conclusions with regard to the optimal management of major blunt renal injuries, we present precise data that are valuable in comparison to other series of patients managed conservatively or surgically.