Complications of urinary tract trauma: case reports
Anna Bujnowska, Aleksandra Jasińska, Agata Będzichowska, Agata Wawrzyniak, Bolesław Kalicki
Trauma is the most common cause of death among children and adolescents. It is estimated that every year trauma accounts for approximately 830,000 children’s deaths worldwide. Urinary tract trauma is relatively rare: it accounts for approximately 3% of all hospitalisations at trauma centres. It usually occurs as a result of high-energy blunt force trauma to the abdomen and pelvis and most commonly coexists with other internal organ injuries. Abdominal trauma causes damage to the upper levels of the urinary tract: the kidneys and ureters. It may be complicated by haemodynamic disturbances, development of urinoma or kidney loss. Pelvic injuries often coexist with damage to the lower level of the urinary tract and lead to intramural complications of the urinary bladder, urethral stenosis, urinary incontinence or erectile dysfunction. In addition, trauma to any level of the urinary tract can result in urinary tract infection, lesser pelvis tissue inflammation, peritonitis or septic shock. Late complications include urolithiasis, vesicoureteral reflux, hydronephrosis and, consequently, renal failure. From the urinary tract perspective, important consequences of spinal injury also include neurogenic bladder and the associated lower urinary tract dysfunction. The article discusses clinical cases of children presenting with early and late complications of urinary tract injury as a result of multiple high-energy trauma.