Kidney Lacerations & Contusions Rina Parrish & Michelle Jones 1 October 2003 AH 322 Eval. Of athletic injuries I

Kidney Lacerations & Contusions

Rina Parrish & Michelle Jones1 October 2003

AH 322Eval. Of athletic injuries I

Kidneycontusions& lacerations

• Kidneys• Paired solid, bean-shaped organs

located in both RUQ & LUQ near spine(the right kidney is slightly lower than the left )

• Function to help control blood volume• Also remove waste from blood in form

of urine


KidneyContusions & Lacerations

• Usually caused by external force causing abnormal extension

• Degree of injury depends on extent of distension, angle, and force of blow

KidneyContusions & Lacerations

•


• Kidneys• Signs & symptoms of Kidney injury

• Hematuria• Bloody discharge or inability to void• Flank pain• + Grey-Turner sign - Ecchymosis in flank• No acute abdominal signs• Possible bony crepitus due to rib fx


• Signs & symptoms of Kidney injury Cont…• Rigidity of back muscles• High pain in the posterior

costoverterbral angle


• Physical Examination• Following vital signs progresses to

• INSPECTION• AUSCULTATION• PERCUSSION• PALPATION & SPECIAL TESTS


• Palpation determines• Signs of acute abdomen such as

• Rebound tenderness• Rigidity• Guarding• General & specific areas of tenderness• Location of deformities• Location & extent of swelling


• INSPECTION• Observe the following

• Level of consciousness• Skin color• Patient's positions, movements &

signs of guarding or apprehension• Respiratory rate & rhythm for

dyspnea or (shortness of breath)


• INSPECTION

• Observe the following• Signs of trauma

• Hemoptysis or (coughing up blood)• Hematemesis or (vomiting up blood)• Ecchymosis• Evidence of mass• Evidence of penetrating trauma• Vomiting


• Auscultation, Percussion & Palpation• each quadrant of the abdominal

cavity is affected & should be included in your physical exam

• When examining the abdomen, each quadrant should be auscultated, percussed & palpated

• AUSCULTATION• Conducted to assess

• Normal vs. abnormal chest sounds• Breathing equality• Depth of breaths• Presence or absence of bowel sounds• Abnormal bowel sounds• Abnormal vascular noises



• AUSCULTATION• Process of listening for sounds produced in

thoracic & abdominal cavity• Stethoscope is used & auscultation is

normally conducted by medical professionals with extensive training & experience in this complex skill


• AUSCULTATION• Conducted to assess

• Normal vs. abnormal chest sounds• Breathing equality• Depth of breaths• Presence or absence of bowel sounds• Abnormal bowel sounds• Abnormal vascular noises


• PERCUSSION• Listen for normal/abnormal sounds

such as • tympany• dullness• Hyperresonance



such as • tympany• dullness• hyperresonance


• PERCUSSION• Usually performed by trained medical

professionals• Involves tapping on various parts of the

body to elicit certain sound• Sound produced assists in determining the

presence or absence of certain conditions• To yield informative results, extensive

training & practice are required



such as • tympany• dullness• hyperresonance


• PALPATION & SPECIAL TESTS• Palpation is process of determining

various abdominal pathologies by pressing with your hands in various quadrants


• Palpation determines • Signs of acute abdomen such as

• Bony crepitus (produced by rough edges of fractured bones rubbing together)

• Asymmetry• Air crepitus (produced by air caught in

subcutaneous tissue)• Muscle rigidity


• IMMEDIATE REFERRAL• Necessary with following S & S

• Diminished chest movement on the affected side

• Shifting or moving of trachea with each breath

• Suspected rib fracture or costochondral separation

• Severe abdominal pain



• Difficulty in breathing• Shortness of breath--inability to catch

breath• Severe pain increasing in chest• Vomiting or coughing up blood



• Prolonged discomfort, sensation of weakness, or pulling in groin

• Superficial protrusion or palpable mass

• Increasing nausea• Vomiting



• Signs of acute abdomen• Rebound tenderness• Rigidity• Guarding

• Signs of shock• Blood in the urine or stool



• Presence of fever• Presence of radiating or referred pain• Any doubt regarding the nature and

severity of the abdominal injury


• Management• Twenty-four hours in the hospital• Gradual increase of fluid intake• Two weeks bed rest • Refrain from any physical activity• Some cases surgery

Kidneycontusions& lacerations• Return to Play

• When all signs & symptoms are cleared

• No pain associated with the contusion• Sometimes wont return to sports at

all• When return surveillance of athlete• Protected padding


Any questions

Documents

Kidney Lacerations & Contusions Rina Parrish & Michelle Jones 1 October 2003 AH 322 Eval. Of athletic injuries I