Nicolaas Johannes Gildenhuys
Stellenbosch University- Tygerberg Medical Campus, South Africa
Posters & Accepted Abstracts: J Nephrol Ther
Introduction: Pre-existing renal lesions predispose kidneys to effects of otherwise insignificant blunt trauma, and may uncommonly present as an incidental finding in the workup of a suspected renal injury. This is a case report of a 28 yearold male diagnosed incidentally with Autosomal Dominant Polycystic Kidney Disease (ADPKD) as part of the workup for suspected kidney injury secondary to assault by a brick. This case study serves as a learning opportunity and future reference in the cases and management of blunt trauma to kidneys with pre-existing lesions. Methods: The study design takes the form of a case report and an overview of the relevant literature. A literature review of the published was done by searching the following databases: PubMed, Google Scholar, Cochrane library, Embase and MEDLINE. Results: The literature search revealed 45 published cases of trauma to pre-existing renal lesions. Eight out of the 45 cases involved trauma to patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) (18%). Four out of the eight cases required nephrectomy, and three cases were managed non-operatively. Conclusion: The conclusions of this study are: Patients with abnormal kidneys require counseling regarding increased risk of injury following blunt abdominal trauma; consideration regarding transfusions for patients that could possibly require renal transplant at a later stage due to risk of antigen sensitization; raised index of suspicion of undiagnosed pre-existing renal lesions in minor blunt renal trauma that present with signs and symptoms out of proportion with the mechanism of trauma and; lowered threshold and the necessity of CT of the abdomen for cases of blunt renal trauma with a history suggesting the possibility of a pre-existing lesion, possibly even in absence of gross haematuria.