Kidney Lacerations

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Kidney Lacerations Contusions

• Rina Parrish Michelle Jones
• 1 October 2003
• AH 322
• Eval. Of athletic injuries I

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Kidneycontusions lacerations

• Kidneys
• Paired solid, bean-shaped organs located in both
  RUQ LUQ near spine(the right kidney is slightly
  lower than the left )
• Function to help control blood volume
• Also remove waste from blood in form of urine

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Kidneycontusions lacerations
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KidneyContusions Lacerations

• Usually caused by external force causing abnormal
  extension
• Degree of injury depends on extent of distension,
  angle, and force of blow

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KidneyContusions Lacerations

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Kidneycontusions lacerations

• Kidneys
• Signs symptoms of Kidney injury
• Hematuria
• Bloody discharge or inability to void
• Flank pain
• Grey-Turner sign - Ecchymosis in flank
• No acute abdominal signs
• Possible bony crepitus due to rib fx

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Kidneycontusions lacerations

• Signs symptoms of Kidney injury Cont
• Rigidity of back muscles
• High pain in the posterior costoverterbral angle

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Kidneycontusions lacerations

• Physical Examination
• Following vital signs progresses to
• INSPECTION
• AUSCULTATION
• PERCUSSION
• PALPATION SPECIAL TESTS

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Kidneycontusions lacerations

• Palpation determines
• Signs of acute abdomen such as
• Rebound tenderness
• Rigidity
• Guarding
• General specific areas of tenderness
• Location of deformities
• Location extent of swelling

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Kidneycontusions lacerations

• INSPECTION
• Observe the following
• Level of consciousness
• Skin color
• Patient's positions, movements signs of
  guarding or apprehension
• Respiratory rate rhythm for dyspnea or
  (shortness of breath)

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Kidneycontusions lacerations

• INSPECTION
• Observe the following
• Signs of trauma
• Hemoptysis or (coughing up blood)
• Hematemesis or (vomiting up blood)
• Ecchymosis
• Evidence of mass
• Evidence of penetrating trauma
• Vomiting

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Kidneycontusions lacerations

• Auscultation, Percussion Palpation
• each quadrant of the abdominal cavity is affected
  should be included in your physical exam
• When examining the abdomen, each quadrant should
  be auscultated, percussed palpated

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Kidneycontusions lacerations

• AUSCULTATION
• Conducted to assess
• Normal vs. abnormal chest sounds
• Breathing equality
• Depth of breaths
• Presence or absence of bowel sounds
• Abnormal bowel sounds
• Abnormal vascular noises

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Kidneycontusions lacerations

• AUSCULTATION
• Process of listening for sounds produced in
  thoracic abdominal cavity
• Stethoscope is used auscultation is normally
  conducted by medical professionals with extensive
  training experience in this complex skill

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Kidneycontusions lacerations

• AUSCULTATION
• Conducted to assess
• Normal vs. abnormal chest sounds
• Breathing equality
• Depth of breaths
• Presence or absence of bowel sounds
• Abnormal bowel sounds
• Abnormal vascular noises

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Kidneycontusions lacerations

• PERCUSSION
• Listen for normal/abnormal sounds such as
• tympany
• dullness
• Hyperresonance

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Kidneycontusions lacerations

• PERCUSSION
• Listen for normal/abnormal sounds such as
• tympany
• dullness
• hyperresonance

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Kidneycontusions lacerations

• PERCUSSION
• Usually performed by trained medical
  professionals
• Involves tapping on various parts of the body to
  elicit certain sound
• Sound produced assists in determining the
  presence or absence of certain conditions
• To yield informative results, extensive training
  practice are required

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Kidneycontusions lacerations

• PERCUSSION
• Listen for normal/abnormal sounds such as
• tympany
• dullness
• hyperresonance

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Kidneycontusions lacerations

• PALPATION SPECIAL TESTS
• Palpation is process of determining various
  abdominal pathologies by pressing with your hands
  in various quadrants

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Kidneycontusions lacerations

• Palpation determines
• Signs of acute abdomen such as
• Bony crepitus (produced by rough edges of
  fractured bones rubbing together)
• Asymmetry
• Air crepitus (produced by air caught in
  subcutaneous tissue)
• Muscle rigidity

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Kidneycontusions lacerations

• IMMEDIATE REFERRAL
• Necessary with following S S
• Diminished chest movement on the affected side
• Shifting or moving of trachea with each breath
• Suspected rib fracture or costochondral
  separation
• Severe abdominal pain

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Kidneycontusions lacerations

• IMMEDIATE REFERRAL
• Necessary with following S S
• Difficulty in breathing
• Shortness of breath--inability to catch breath
• Severe pain increasing in chest
• Vomiting or coughing up blood

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Kidneycontusions lacerations

• IMMEDIATE REFERRAL
• Necessary with following S S
• Prolonged discomfort, sensation of weakness, or
  pulling in groin
• Superficial protrusion or palpable mass
• Increasing nausea
• Vomiting

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Kidneycontusions lacerations

• IMMEDIATE REFERRAL
• Necessary with following S S
• Signs of acute abdomen
• Rebound tenderness
• Rigidity
• Guarding
• Signs of shock
• Blood in the urine or stool

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Kidneycontusions lacerations

• IMMEDIATE REFERRAL
• Necessary with following S S
• Presence of fever
• Presence of radiating or referred pain
• Any doubt regarding the nature and severity of
  the abdominal injury

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Kidneycontusions lacerations

• Management
• Twenty-four hours in the hospital
• Gradual increase of fluid intake
• Two weeks bed rest
• Refrain from any physical activity
• Some cases surgery

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Kidneycontusions lacerations

• Return to Play
• When all signs symptoms are cleared
• No pain associated with the contusion
• Sometimes wont return to sports at all
• When return surveillance of athlete
• Protected padding

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Kidneycontusions lacerations

• Any questions