ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Renal trauma in a pediatric Level 1 trauma center: morbidity, mortality, and the role of renal scintigraphy.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePediatric renal trauma is uncommon but potentially serious, and is often managed conservatively. Complications may occur, and the clinical value of renal scintigraphy during follow-up remains unclear. This study aimed to assess morbidity and mortality after pediatric renal trauma and to assess the clinical value of renal scintigraphy during follow-up.
methodsThis retrospective single-center cohort study included pediatric trauma patients (< 18 years) with renal injuries admitted to a Level 1 trauma center in the Netherlands between January 1, 2001, and December 31, 2024. Mortality and in-hospital complications were assessed, and associations between renal scintigraphy abnormalities and complications during follow-up were evaluated.
resultsA total of 72 patients were included, of whom all injuries resulted from blunt trauma. Conservative management was applied in 88% of cases; embolization and nephrectomy were performed in 8% and 3% of patients, respectively. In-hospital mortality was 11% and was attributed exclusively to concomitant traumatic brain injury. Complications occurred in 25% of patients, primarily infections (19%), followed by hypertension during follow up (4%). Renal scintigraphy was performed in 53% of patients, predominantly in those with high-grade injuries; abnormalities were frequently observed (77%) but did not correlate with the occurrence of hypertension, proteinuria, or renal insufficiency during follow-up.
conclusionPediatric renal trauma, including high-grade injuries, can often be managed conservatively, and most complications can be treated using medical therapy or minimally invasive interventions. Renal scintigraphy showed no clear association with long-term morbidity and had limited additional value in routine follow-up. Given the potential for late-onset hypertension, structured long-term clinical surveillance with periodic monitoring of blood pressure, proteinuria, and renal function is warranted, particularly after high-grade injuries.
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