Prognosis 2 (Renal Trauma)

hage_38a_n.jpg: 15.4-year-old boy with an abdominal tumor on the right side. The work-up examinations showed a large retroperitoneal mass with an extended zone of absent vascularization. During surgery a large mass becomes visible like a parenchymatous organ. Figure hage_38b_n.jpg: On incision in the middle part there is an evacuation of an opaque fluid under pressure. Figure hage_38c_n.jpg: Parenchymatous organ divided in two parts with a large cavity in between and around it; the capsule of the cavity has been divided (notice the retention threads). The diagnosis is a former grade 4 (IV) rupture of the right kidney and its natural history. The large leak of the renal pelvis led to an extravasation of urine and a renal pseudocyst. The case report illustrates the necessity to consider in every abdominal tumor in childhood a sequel of a former abdominal trauma (pseudocysts after blunt abdominal trauma of kidney, spleen, or pancreas), and to recognize and to operate or at least to drain every urinary leakage in acute renal trauma.