https://doi.org/10.4081/ecj.2023.11577

Renal trauma during a rugby tackle

Vol. 19 No. 3 (2023)
Submitted: 9 July 2023
Accepted: 21 August 2023
Published: 13 September 2023
Sports, trauma, kidney, hematuria
Abstract Views: 561
PDF: 275
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Authors

Sohil Pothiawala
drsohilpothiawala@yahoo.com
https://orcid.org/0000-0002-4789-4326
Trauma & Emergency Services, Auckland City Hospital, Auckland, New Zealand; Department of Emergency Medicine, Woodlands Health, Singapore.
Rebecca Schroll
https://orcid.org/0000-0002-2136-3869
Trauma Surgeon, Auckland City Hospital, Auckland, New Zealand.

Rugby-related renal trauma is rare and identification of a young patient with renal trauma secondary to sports who requires observation versus further radiological evaluation in the emergency department (ED) poses a diagnostic challenge. We report a case of a 16-year-old girl who presented to the ED with abdominal pain after being tackled during a game of rugby. Examination revealed tenderness over the right lateral lower ribs and right flank. Blood tests were normal and bedside ultrasound did not show any free intraperitoneal fluid. Urinalysis showed gross hematuria. She was pain-free after analgesia but had a syncopal episode in the ED. A computed tomography (CT) scan of the abdomen and pelvis showed a complex right lower pole renal laceration and she was admitted to the Intensive Care Unit. She remained stable and was discharged. Assessment with urinalysis, hematocrit, and creatinine is required during the evaluation of a patient with suspected renal trauma. CT scan is the imaging modality for the diagnosis and grading of renal injury. Conservative treatment is the mainstay of therapy, but some patients require angioembolization of surgical intervention. Patients must discuss with their physician regarding the optimal timing of return to rugby. Rugby-related renal trauma is rare and poses a challenge for emergency physicians regarding their evaluation and management in the ED. AAST-OIS grading of renal trauma on CT imaging helps guide appropriate management decisions.

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Google Scholar
Europe PMC
Harper K, Shah KH. Renal trauma after blunt abdominal injury. J Emerg Med 2013;45:400-4. DOI: https://doi.org/10.1016/j.jemermed.2013.03.043
Freeman CM, Kelly ME, Nason GJ, et al. Renal trauma: the rugby factor. Curr Urol 2015;8:133–7. DOI: https://doi.org/10.1159/000365704
Hagedorn JC, Fox N, Ellison JS, et al. Pediatric blunt renal trauma practice management guidelines: Collaboration between the Eastern Association for the Surgery of Trauma and the Pediatric Trauma Society. J Trauma Acute Care Surg 2019;86:916-25. DOI: https://doi.org/10.1097/TA.0000000000002209
Kim JK, Koyle MA, Lee MJ, et al. A systematic review of genitourinary injuries arising from rugby and football. J Pediatr Urol 2020;16:130-48. DOI: https://doi.org/10.1016/j.jpurol.2019.12.019
Kitrey ND, Campos-Juanatey F, Hallscheidt P, et al. EAU guidelines on urological trauma. Accessed 5th July 2023. Available from: https://uroweb.org/guidelines/urological-trauma/panel.
Alsono RC, Nacenta SB, Martinez PD, et al. Kidney in danger: CT findings of blunt and penetrating trauma. Radiographics 2009;29:2033–53. DOI: https://doi.org/10.1148/rg.297095071
McAndrew JD, Corriere JN Jr. Radiographic evaluation of renal trauma: evaluation of 1103 consecutive patients. Br J Urol 1994;73:352–4. DOI: https://doi.org/10.1111/j.1464-410X.1994.tb07594.x
Hardeman SW, Husmann DA, Chinn HK, Peters PC. Blunt urinary tract trauma: identifying those patients who require radiological diagnostic studies. J Urol 1987;138:99–101. DOI: https://doi.org/10.1016/S0022-5347(17)43005-9
Kozar RA, Crandall M, Shanmuganathan K, et al. Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg 2018;85:1119-22. DOI: https://doi.org/10.1097/TA.0000000000002058
Hom J. The risk of intra-abdominal injuries in pediatric patients with stable blunt abdominal trauma and negative abdominal computed tomography. Acad Emerg Med 2010;17:469–75. DOI: https://doi.org/10.1111/j.1553-2712.2010.00737.x
Alhazmi HH. Sport-related renal injuries among children: A review of literature. Saudi J Sports Med 2016;16:93-100. DOI: https://doi.org/10.4103/1319-6308.180133

How to Cite

Pothiawala, S., & Schroll, R. (2023). Renal trauma during a rugby tackle. Emergency Care Journal, 19(3). https://doi.org/10.4081/ecj.2023.11577
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