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MATERIALS AND METHODS: Within 20 yrs, 76 children aged 28 yrs with kidney trauma were under observation, and 35 of them had associated trauma. Clinical, instrumental, and radiological methods were used in the diagnosis. RESULTS: Of the 76 children with closed kidney trauma, 23 were diagnosed with kidney contusion, 14 with kidney injury with subcapsular hematoma, 16 with kidney injury with rupture of the capsule and perirenal urohematoma, 21 with kidney rupture and damage to the calyxpelvic system, and 2 with traumatic hydronephrotic kidney. Conservative treatment was carried out in 49 (64.4%) children and surgical treatment in 28 (25.6%). In the long term, 28 children with kidney injuries and treated conservatively were examined. Complications were found in nine children: pyeloectasia, deformation of the calyxpelvic system, pyelonephritis, and renal hypertension. Organ-preserving surgery was performed in 22 (28.9%) children and nephrectomy in 5 (6.6%) children. As long-term results: the function of the operated kidneys was satisfactory, some changes occurred in the calyxpelvic systems, and no data for pyelonephritis was found. CONCLUSION: Renal injuries with subcapsular rupture and perirenal urohematoma should be surgically treated to prevent severe long-term complications. In unclear cases, the choice can be a two-stage organ-preserving operation for the so-called crushing of the kidney.

Nontraumatic, spontaneous parenchymal kidney rupture is a rare clinical entity that may cause extensive hemorrhage, hypovolemic shock, and death. Spontaneous nontraumatic kidney rupture is extremely rare in systemic lupus erythematosus (SLE) patients. Because of the high morbidity and mortality rates, an immediate establishment of the diagnosis and treatment are necessary. We present the case of a 30-year-old female with spontaneous parenchymal rupture of the right kidney who had renal failure due to SLE and presented with atraumatic sudden right flank pain during hemodialysis treatment. To our knowledge, this case is the second report of SLE manifesting as spontaneous kidney rupture in the literature.

The objective of the present study was the expert assessment of the morphological signs of renal lesions depending on the type of deformation associated with a blunt trauma. The authors proposed the algorithm for the description of a kidney damage taking into consideration the specific morphological features associated with a blunt trauma. The pathomorphological changes in the kidney tissue under the normal hemodynamic conditions and in the case of hemorrhagic shock at different times after the injury taking into account its organ specificity make it possible to reliably predict the duration of the post-traumatic period.Цель работы - экспертная оценка морфологии почки в зависимости от вида деформации при тупой травме. Приведен алгоритм описания поврежденного органа с учетом выявленных морфологических особенностей. Изучены патоморфологические изменения тканей почки в условиях нормоволемии и геморрагического шока в различные сроки после травмы с учетом ее органоспецифичности, которые позволяют обоснованно высказываться о продолжительности посттравматического периода.Цель работы — экспертная оценка морфологии почки в зависимости от вида деформации при тупой травме. Приведен алгоритм описания поврежденного органа с учетом выявленных морфологических особенностей. Изучены патоморфологические изменения тканей почки в условиях нормоволемии и геморрагического шока в различные сроки после травмы с учетом ее органоспецифичности, которые позволяют обоснованно высказываться о продолжительности посттравматического периода.

Nontraumatic, spontaneous parenchymal kidney rupture is a rare clinical entity that may cause extensive hemorrhage, hypovolemic shock, and death. Spontaneous nontraumatic kidney rupture is extremely rare in systemic lupus erythematosus (SLE) patients. Because of the high morbidity and mortality rates, an immediate establishment of the diagnosis and treatment are necessary. We present the case of a 30-year-old female with spontaneous parenchymal rupture of the right kidney who had renal failure due to SLE and presented with atraumatic sudden right flank pain during hemodialysis treatment. To our knowledge, this case is the second report of SLE manifesting as spontaneous kidney rupture in the literature. © 2016 International Society for Hemodialysis.

The existing treatment options for pediatric urolithiasis are endoscopic methods. Extracorporeal shockwave lithotripsy (SWL) is the first-line option for most of the kidney stones smaller than 1 cm in diameter. For larger stones or refractory cases, minimally invasive surgical methods are preferred. Percutaneous nephrolithotomy (PCNL) is a well-established treatment modality for most patients. This technique has shown evolution also in children so that miniaturized or tubeless methods could now be performed. Recent series show that flexible ureteroscopy is also becoming an important treatment option in the pediatric urology armamentarium for treating the calyceal and lower pole stones. Open surgery has a very limited role and it may be of use when there is a need to do an adjuvant reconstructive surgery. With the increasing experience, laparoscopic surgery is becoming an alternative option that may have potential to replace the open techniques.

Xanthogranulomatous pyelonephritis (XGP) is an uncommon and aggressive form of inflammation of the renal parenchyma particularly resulting in diffuse renal destruction. A previously healthy 25-year-old woman was admitted to our clinic with right flank pain of sudden onset, nausea and high fever. Computed tomography revealed a mass (12 x 7 cm in diameter) around the right kidney with extension to pelvis and paravertebral space. Flank incision was made urgently and a very large perirenal haematoma and abscess formation were found caused by the rupture located at the posterior side of the right kidney. A right nephrectomy was performed and abscess material was evacuated from the perirenal area. XGP was diagnosed by histopathologic examination of the resected kidney. Although XGP regularly demonstrates a gradual progression and presents with nonspecific symptoms, the situation may appear with complications as in our case. Our patient presented with renal rupture and perirenal abscess extending to the pelvis and paravertebral space. To the best of our knowledge, this is the first report of XGP presenting with spontaneous renal rupture in the English literature.

Toourknowledge, wepresent the first case in the English literature of kidneyrupture accompanied by massive PVT. Discussion on thetreatment of this patient focused on the question whetherthemassiveportalveinthrombosiswasofacuteonsetormayhave been pre-existent. Anticoagulant therapy would beindicated in case of acute PVT, but the concomitant kidneyrupture is a contra-indication for rigorous anticoagulativetreatment.

Resume L’uroperitoine postnatal est exceptionnel au regard des autres causes d’epanchement peritoneal de cette tranche d’âge et de sa frequence antenatale. Une insuffisance renale aigue anurique chez un garcon premature, associee a un epanchement peritoneal a fait diagnostiquer une rupture spontanee de la vessie. Une reparation chirurgicale a ete effectuee. Aucun facteur predisposant n’a pu etre identifie a cet accident rarissime. L’analyse des caracteres biochimiques de l’epanchement avait permis d’en affirmer l’origine urinaire, d’en comprendre le mecanisme et de proposer un traitement.

The Authors describe their limited but significant experience (101 cases) regarding the diagnostic and therapeutic approach to patients with multiple traumas with involvement of the urogenital tract. Approach to the renal trauma in these patients appears to be highly controversial. Experience has shown that in cases of severe renal trauma, when the urologist is called immediately to visit the patient so that a complete and correct urological diagnostic procedure can be planned, the possibilities of conservative treatment to save the kidney are greater.

Spontaneous rupture of kidney is a rare clinical entity. A 35-year-old female presented in emergency with left flank pain and features suggestive of haemorrhagic shock. Investigations showed rupture of kidney with perinephric haematoma. Emergency left nephrectomy was done. Patient was discharged in satisfactory condition. Nephrolithiasis with secondary bacterial infection rarely presents as spontaneous kidney rupture. In presence of haemorrhagic shock management is emergency surgery.

Kidney spontaneous rupture is not a recognized complication neither for amyloidosis nor of autologous stem cell transplantation (ASCT). A 46-year-old white woman, affected by nephrotic syndrome, was diagnosed as AL amyloidosis by renal biopsy. We report the singular case of a bilateral spontaneous kidney rupture during ASCT for AL with renal rescue.

A case of spontaneous, but not contemporary rupture of both kidneys in a 42-year-old man with tuberous sclerosis is described. Despite the high incidence of renal involvement, chronic renal failure due to replacement and compression of renal tissue by hamartomas is rare. We reviewed 25 cases in the literature and found only 1 other case which necessitated maintenance hemodialytic treatment for kidney rupture. It is suggested that early diagnosis and conservative partial nephrectomy could prevent or delay the onset of chronic renal failure, malignant transformation and dramatic rupture of hamartomas.

Spontaneous rupture of the kidney is an uncommon entity. In most cases the non-traumatic rupture is associated with underlying diseases of the kidney, the most frequent being renal tumours. We report the case of a spontaneous kidney rupture due to a renal metastasis from an adenocarcinoma of the colon.

Spontaneous ruptures of the kidney frequently require an emergency surgical intervention and the underlying pathology often only becomes clear intraoperatively. On the basis of our own cases the clinical management of the symptom 'rupture of the kidney' is discussed particularly referring to renal tumors.

Choriocarcinoma is a rapidly growing tumor that characteristically outgrows its blood supply. We report a rare case of metastatic choriocarcinoma presenting with acute right flank pain due to kidney rupture secondary to renal metastasis. The renal metastasis was embolised to stanch blood for control of hemorrhage. A brief review of the imaging features and therapeutic options for the ruptured renal metastases is discussed along with the case.

Bericht uber zwei Falle einer geburtsmechanischen Nierenverletzung beim Neugeborenen. Hingewiesen wird auf die gemeinsamen Zeichen bei beiden Kindern: komplikationslose Geburt aus 3. bzw. 4. Schwanger

The hydrostatic pressure, intrapelvic volume, and specific elasticity and strength of strips of tissue from the parenchyma and the pelvis of eight hydronephrotic kidneys were investigated and compared with the tissue characteristics of the pelvis of four control kidneys. Hydronephorsis manifested itself by a sixfold reduction of tissue strength, and dynamically by a ninefold reduction of the energy absorptive capacity of the parenchyma as compared with the pelvis. Its further response to trauma appeared to be influenced by internal pressure, the law of mass variation, and the energy absorptive capacity of surrounding anatomical structures. The vulnerability of the hydronephrotic kidney in situ depends on its volume and topography, the parenchyma being the part that may be regarded as the site most predisposed to rupture.

Two cases of kidney rupture associated with hypertension are described, and the multiform traumatic changes causing it are surveted Renal arteriography is recommended not only in the early but also in the late stages of hypertension of this type, which responds to definitive treatment.

Background: Ruptured renal neoplasms can be a catastrophic clinical presentation. Angiomyolipoma is the commonest renal tumor which presents in this fashion. Renal sarcomas are rare renal neoplasms. Renal leiomyosarcomas are the most common histological subtype of renal sarcomas, accounting for approximately 50–60% of the reported cases. These tumors are usually peripherally located and appear to arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall. Case presentation: A 70 years old male, with hypertension and ischemic disease, developed acute left flank pain. The general physician evaluated this using ultrasound, which showed a solid left renal mass. Two weeks later, he presented in the emergency room in a state of shock with a palpable flank mass. CT scan of the abdomen showed a large heterogeneous mass lesion in the left perinephric space with minimal post contrast enhancement. Per-operatively, large retroperitoneal hematoma was found within Gerota's fascia along with spleen plastered to the upper limit of hematoma. Nephrectomy and splenectomy were performed. Postoperative course was uneventful and patient was discharged on the 10th post-operative day. Histopathological evaluation of the specimen showed high-grade leiomyosarcoma Conclusions: Spontaneous rupture of renal neoplasm is a rare clinical presentation. Angiomyolipoma is the commonest cause of spontaneous rupture of the kidney. Presentation of a leimyosarcoma as a ruptured renal neoplasm has not been previously reported in the English literature. Background Leiomyosarcomas of the kidney make up to 0.5–1.5% of malignant renal tumors in adults [2]. There is no difference in the gender distribution with a mean age at diagnosis in the sixth decade. They typically presents with the

Spontaneous kidney rupture as the initial manifestation of polyarteritis nodosa is rare. We present 4 such patients who underwent nephrectomy. We suggest primary nephrectomy in patients with spontaneous kidney rupture and resultant retroperitoneal hematoma in whom no preoperative diagnosis is available.

A case of spontaneous rupture of a renal angiomyolipoma with massive retroperitoneal haemorrhage necessitating emergency nephrectomy is presented. Diagnostic features and treatment of angiomyolipoma are discussed.

A case of traumatic kidney rupture, showing almost immediate abdominal signs but delayed urinary findings, was recently observed by the surgical service of the Rochester General Hospital. A girl, aged 8 years, of Italian birth, was carried to the children's pavilion of the hospital, complaining of pain in the back. According to the history, the child had stepped into an open coal-hole and had fallen 12 feet into a cellar, striking on a dirt floor. The girl was unable to tell of the details as to whether or not she struck a protruding ledge or post. The history further states that she was stunned and had vomited once. She managed to walk home after the accident, but the mother noted that she became listless and complained more and more of pain in the lower part of the back. On admission to the ward, eight hours after the fall, the child