A kidney contusion is an injury to the kidney due to blunt force trauma. It is among the most common kidney traumas.
What is a kidney contusion?
In medicine, a kidney contusion is also known as a renal contusion or renal contusion. In this case, both a single kidney and both organs can be affected by blunt force trauma. According to the definition of the AAST (American Association for the Surgery of Trauma), renal contusion is considered the mildest form of renal trauma. It is also the most common type of renal trauma, accounting for approximately 70 percent of all cases. Accompanying the renal contusion is a bruise (hematoma), swelling, and pain in the flank region.
Causes
Renal contusion is often associated with polytrauma. Those at risk include people who suffer from kidney malformations and children. Men are up to four times more likely to be affected by renal contusion than the female sex. In about 80 to 90 percent of all cases, kidney contusions are caused by traffic accidents or sports injuries. However, sometimes a physical injury can also be the reason for the contusion. Medical science classifies kidney contusions into several different degrees of severity. They range from grade I to grade V.
About two-thirds of all kidney injuries correspond to grade I. In this case, there is a contusion of the kidney with a hematoma inside the connective tissue capsule that surrounds the human kidney. The hematoma does not expand as it progresses. Although the functional tissue of the kidney is displaced, it does not sustain damage. In severity II, there is a tear of the renal parenchyma of less than one centimeter. Likewise, there may be a perirenal hematoma. Grade III is when the parenchymal tear is more than one centimeter. Grade II and III can usually still be treated conservatively. In the case of severity grade IV and V, there are severe kidney injuries as well as damage to the draining urinary tract. Part of the functional kidney tissue may have been destroyed. Even a rupture of the draining urinary tract is possible. Therefore, surgery is considered necessary for treatment.
Symptoms, complaints and signs
The symptoms of a kidney contusion can vary and sometimes be nonspecific. Complaints do not always appear immediately after the accident, but occur somewhat later. Most patients suffer from severe pain on the affected side of the flank. This is usually probing, dull or stabbing and manifests itself on the posterior side at the level of the navel. Sometimes the pain radiates toward the back or abdomen. For example, some patients with a kidney contusion suffer from intense back pain and tension. This is due to a pronounced interconnection of the nerve plexuses, which leads to spasm of the back muscles. Another typical symptom of renal contusion is the formation of a hematoma with swelling. Also of importance is hematuria, in which blood is seen in the urine. Physicians distinguish between microhematuria and macrohematuria. Microhematuria is when the urine is barely discolored by the blood, while in macrohematuria the affected person can already see the reddish discoloration with the eye. In addition, complete red blood cells that have remained intact can be detected in the urine. However, even if the urine has a normal coloration, renal hemorrhage cannot be ruled out. However, hematuria is considered an indication of numerous other conditions such as urinary stones or urinary tract infections, so it cannot in principle be attributed to a renal contusion. Some patients also suffer from nausea and vomiting in the context of a renal contusion. If the symptoms do not improve or even worsen, a visit to the doctor is recommended.
Diagnosis and course of the disease
At the doctor’s office, the first step is to take a medical history to determine possible accidents as triggers. After that, a physical examination takes place. Identifying a kidney contusion is not considered difficult. However, it is important to rule out severe kidney damage that might require surgery. The doctor palpates the injured area and looks for swelling, redness and bruising.Pressure pain is a typical sign of a kidney contusion or bruise. The physician also takes a urine sample, which is checked for bleeding. Special test strips are used to detect microhematuria. Imaging examination methods are also available to rule out possible uncertainties. These include sonography (ultrasound examination), computed tomography (CT), and magnetic resonance imaging (MRI), which can be used to determine the exact extent of the kidney injury. Although a kidney contusion is very painful, it rarely results in prolonged damage. Usually, the contusion heals on its own after a few days, so a positive prognosis can be given.
Complications
Due to the renal contusion, the affected person usually suffers from severe pain in the area of the kidneys and the flanks. It is not uncommon for this pain to spread to other regions of the body in the process, such as the back or hips. In the worst case, the affected person dies as a result of the kidney contusion if renal insufficiency develops. Patients are then usually dependent on dialysis or a kidney transplant. Pain in the abdomen may also occur due to the kidney contusion, and there is tension in the back. Urine may possibly be red in color due to bleeding. The risk of urinary stones or urinary tract infections may also increase significantly due to the kidney contusion. Sufferers also experience vomiting or nausea in some cases. The pain of the kidney contusion can be treated with ordinary painkillers. In this case, there are no particular complications. However, in severe cases, surgical interventions are necessary to prevent the death of the affected person. It is possible that the patient’s life expectancy will be limited due to the kidney contusion.
When should you see a doctor?
A kidney contusion can present in different degrees of severity, so it is not always mandatory to seek medical or even hospital treatment. In most cases, such a contusion is caused by brute force, so that affected individuals complain of severe pain on the respective side. At the first sign of kidney pain, an appropriate doctor should definitely be consulted in order to avoid serious complications. In particularly bad cases, the pain can even spread to the back. If you see a doctor early, you can expect a full and speedy recovery. If a visit to the doctor is not made, the pain is likely to intensify considerably. In the worst case, the kidney may even fail completely, posing an acute threat to life. Blood may be visible in the urine, which is a sign of bleeding in the kidney. At the latest with this symptom, a doctor should be consulted immediately. In the case of slight bruising of the kidney, a visit to the doctor can be dispensed with. The pain subsides on its own after a few days, so no medical or drug treatment is necessary.
Treatment and therapy
Treatment of a kidney contusion consists of several days of bed rest and mild cooling of the bruised area. The application of the so-called PECH rule is considered recommended. The patient should also be given plenty of fluids. This is a good way to support the healing process. Active substances such as ibuprofen or diclofenac are suitable for treating the pain. Almost always, a renal contusion can be treated conservatively. Surgery takes place only in the case of high-grade injuries to the kidneys. Ultrasound control examinations and a urine examination must take place to rule out worse impairments with certainty.
Outlook and prognosis
The prognosis for a contusion of the kidney depends on the extent of the trauma sustained. In the case of a mild contusion, freedom from symptoms can be documented after only a few weeks. There will be pain, swelling as well as bruising. However, if there is no impairment of the functioning of the kidney, the human organism often regenerates itself with sufficient rest and sparing. Depending on the general state of health, there is an improvement in symptoms after just a few days. For some sufferers, the effects can burden everyday life for several months.In the case of a more severe kidney contusion, further secondary disorders are to be expected. In addition to tension and internal bleeding, irreversible organ damage can occur. In addition, the risk of secondary diseases increases. The affected person is susceptible to infections and may therefore suffer from further health disorders. If a severe kidney contusion is diagnosed, surgical intervention must be performed. Possible internal bleeding must be stopped as quickly as possible to rule out any risk to life due to hemorrhage. In addition, it must be checked how severe the tissue injuries are. If irreversible damage to the organ occurs, long-term therapy must be given. In addition to drug treatment, dialysis may be necessary. If the course of the disease is unfavorable, the need for a donor organ may become relevant to ensure survival.
Prevention
Preventive measures against renal contusion are not known. Occasionally, it may be useful to avoid aggressive contact sports.
Aftercare
In most cases, the affected person has very few and also very limited options for aftercare in the event of a kidney contusion. For this reason, the affected person should ideally see a doctor at the first signs and symptoms of the disease to prevent the occurrence of other complaints and complications. The further course of the kidney contusion is very much dependent on the time of diagnosis, so that the life expectancy cannot be predicted in this case either. The person affected by a kidney contusion should drink a lot of fluids. In general, a healthy lifestyle with a healthy diet can also have a very positive effect on the further course of the disease, although the patient should refrain from smoking and alcohol. In many cases, it is also necessary to take various medications to alleviate and limit the symptoms. The patient should always ensure that the medication is taken regularly and in the prescribed dosage. If there are any uncertainties or questions, a doctor should be consulted first. As a rule, regular checks by a doctor are also very important in the case of renal contusion.
This is what you can do yourself
In case of a kidney contusion, the affected person needs sufficient rest and sparing. Physical overexertion or sports activities should be avoided. Movements should be performed slowly and evenly so that the organism is not exposed to further overload. During the regeneration and healing phase, situations associated with stress and hectic activity should be avoided. In addition to physical stress, emotional excitement should also be reduced to a minimum. The organism needs a sufficient amount of oxygen and a healthy as well as balanced diet every day. The consumption of harmful substances such as nicotine or alcohol is to be completely refrained from. Since a lack of exercise is initiated during the healing phase, the diet should not be too fatty. The number of calories consumed should be adjusted to the needs of the organism, so that overweight does not develop. The affected person often adopts a protective posture due to the complaints. In order to prevent muscular complaints or incorrect posture, attention should be paid to balancing movements or lying positions. The body can be supported with an adequate supply of heat to reduce or prevent possible tension. Since the kidney contusion is associated with severe pain, the affected person can promote his well-being with mental techniques. Autogenic training or meditative states help to establish an inner balance and support mental powers.
